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Helsingen LM, Løberg M, Refsum E, Gjøstein DK, Wieszczy P, Olsvik Ø, Juul FE, Barua I, Jodal HC, Herfindal M, Mori Y, Jore S, Lund-Johansen F, Fretheim A, Bretthauer M, Kalager M. Covid-19 transmission in fitness centers in Norway - a randomized trial. BMC Public Health 2021; 21:2103. [PMID: 34789188 PMCID: PMC8595959 DOI: 10.1186/s12889-021-12073-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 10/21/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Closed fitness centers during the Covid-19 pandemic may negatively impact health and wellbeing. We assessed whether training at fitness centers increases the risk of SARS-CoV-2 virus infection. METHODS In a two-group parallel randomized controlled trial, fitness center members aged 18 to 64 without Covid-19-relevant comorbidities, were randomized to access to training at a fitness center or no-access. Fitness centers applied physical distancing (1 m for floor exercise, 2 m for high-intensity classes) and enhanced hand and surface hygiene. Primary outcomes were SARS-CoV-2 RNA status by polymerase chain reaction (PCR) after 14 days, hospital admission after 21 days. The secondary endpoint was SARS-CoV-2 antibody status after 1 month. RESULTS 3764 individuals were randomized; 1896 to the training arm and 1868 to the no-training arm. In the training arm, 81.8% trained at least once, and 38.5% trained ≥six times. Of 3016 individuals who returned the SARS-CoV-2 RNA tests (80.5%), there was one positive test in the training arm, and none in the no-training arm (risk difference 0.053%; 95% CI - 0.050 to 0.156%; p = 0.32). Eleven individuals in the training arm (0.8% of tested) and 27 in the no-training arm (2.4% of tested) tested positive for SARS-CoV-2 antibodies (risk difference - 0.87%; 95%CI - 1.52% to - 0.23%; p = 0.001). No outpatient visits or hospital admissions due to Covid-19 occurred in either arm. CONCLUSION Provided good hygiene and physical distancing measures and low population prevalence of SARS-CoV-2 infection, there was no increased infection risk of SARS-CoV-2 in fitness centers in Oslo, Norway for individuals without Covid-19-relevant comorbidities. TRIAL REGISTRATION The trial was prospectively registered in ClinicalTrials.gov on May 13, 2020. Due to administrative issues it was first posted on the register website on May 29, 2020: NCT04406909 .
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Affiliation(s)
- Lise M. Helsingen
- grid.5510.10000 0004 1936 8921Clinical Effectiveness Research Group, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Magnus Løberg
- grid.5510.10000 0004 1936 8921Clinical Effectiveness Research Group, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Erle Refsum
- grid.5510.10000 0004 1936 8921Clinical Effectiveness Research Group, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Dagrun Kyte Gjøstein
- grid.5510.10000 0004 1936 8921Clinical Effectiveness Research Group, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Paulina Wieszczy
- grid.5510.10000 0004 1936 8921Clinical Effectiveness Research Group, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Ørjan Olsvik
- Institute of Medical Biology, Norwegian Arctic University, Tromsø, Norway
| | - Frederik E. Juul
- grid.5510.10000 0004 1936 8921Clinical Effectiveness Research Group, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Ishita Barua
- grid.5510.10000 0004 1936 8921Clinical Effectiveness Research Group, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Henriette C. Jodal
- grid.5510.10000 0004 1936 8921Clinical Effectiveness Research Group, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Magnhild Herfindal
- grid.5510.10000 0004 1936 8921Clinical Effectiveness Research Group, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Yuichi Mori
- grid.5510.10000 0004 1936 8921Clinical Effectiveness Research Group, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Solveig Jore
- grid.418193.60000 0001 1541 4204Norwegian Institute of Public Health, Oslo, Norway
| | - Fridtjof Lund-Johansen
- grid.55325.340000 0004 0389 8485Department of Immunology, Oslo University Hospital, Oslo, Norway
| | - Atle Fretheim
- grid.418193.60000 0001 1541 4204Norwegian Institute of Public Health, Oslo, Norway
| | - Michael Bretthauer
- grid.5510.10000 0004 1936 8921Clinical Effectiveness Research Group, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Mette Kalager
- grid.5510.10000 0004 1936 8921Clinical Effectiveness Research Group, University of Oslo and Oslo University Hospital, Oslo, Norway
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Helsingen LM, Refsum E, Gjøstein DK, Løberg M, Bretthauer M, Kalager M, Emilsson L. The COVID-19 pandemic in Norway and Sweden - threats, trust, and impact on daily life: a comparative survey. BMC Public Health 2020; 20:1597. [PMID: 33097011 PMCID: PMC7582026 DOI: 10.1186/s12889-020-09615-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 09/27/2020] [Indexed: 11/13/2022] Open
Abstract
Background Norway and Sweden have similar populations and health care systems, but different reactions to the COVID-19 pandemic. Norway closed educational institutions, and banned sports and cultural activities; Sweden kept most institutions and training facilities open. We aimed to compare peoples’ attitudes towards authorities and control measures, and perceived impact of the pandemic and implemented control measures on life in Norway and Sweden. Methods Anonymous web-based surveys for individuals age 15 or older distributed through Facebook using the snowball method, in Norway and Sweden from mid-March to mid-April, 2020. The survey contained questions about perceived threat of the pandemic, views on infection control measures, and impact on daily life. We performed descriptive analyses of the responses and compared the two countries. Results 3508 individuals participated in the survey (Norway 3000; Sweden 508). 79% were women, the majority were 30–49 years (Norway 60%; Sweden 47%), and about 45% of the participants in both countries had more than 4 years of higher education. Participants had high trust in the health services, but differed in the degree of trust in their government (High trust in Norway 17%; Sweden 37%). More Norwegians than Swedes agreed that school closure was a good measure (Norway 66%; Sweden 18%), that countries with open schools were irresponsible (Norway 65%; Sweden 23%), and that the threat from repercussions of the mitigation measures were large or very large (Norway 71%; Sweden 56%). Both countries had a high compliance with infection preventive measures (> 98%). Many lived a more sedentary life (Norway 69%; Sweden 50%) and ate more (Norway 44%; Sweden 33%) during the pandemic. Conclusion Sweden had more trust in the authorities, while Norwegians reported a more negative lifestyle during the pandemic. The level of trust in the health care system and self-reported compliance with preventive measures was high in both countries despite the differences in infection control measures.
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Affiliation(s)
- Lise M Helsingen
- Clinical Effectiveness Research group, Institute for Health and Society, University of Oslo and Oslo University Hospital, PO Box 1089, Blindern, 0318, Oslo, Norway.
| | - Erle Refsum
- Clinical Effectiveness Research group, Institute for Health and Society, University of Oslo and Oslo University Hospital, PO Box 1089, Blindern, 0318, Oslo, Norway
| | - Dagrun Kyte Gjøstein
- Clinical Effectiveness Research group, Institute for Health and Society, University of Oslo and Oslo University Hospital, PO Box 1089, Blindern, 0318, Oslo, Norway
| | - Magnus Løberg
- Clinical Effectiveness Research group, Institute for Health and Society, University of Oslo and Oslo University Hospital, PO Box 1089, Blindern, 0318, Oslo, Norway
| | - Michael Bretthauer
- Clinical Effectiveness Research group, Institute for Health and Society, University of Oslo and Oslo University Hospital, PO Box 1089, Blindern, 0318, Oslo, Norway
| | - Mette Kalager
- Clinical Effectiveness Research group, Institute for Health and Society, University of Oslo and Oslo University Hospital, PO Box 1089, Blindern, 0318, Oslo, Norway
| | - Louise Emilsson
- Clinical Effectiveness Research group, Institute for Health and Society, University of Oslo and Oslo University Hospital, PO Box 1089, Blindern, 0318, Oslo, Norway.,Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway.,Vårdcentralen Årjäng and Centre for Clinical Research, County Council of Värmland, Värmland, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Gjøstein DK, Huitfeldt A, Løberg M, Adami HO, Garborg K, Kalager M, Bretthauer M. Incentives and participation in a medical survey. Tidsskr Nor Laegeforen 2016; 136:1082-7. [PMID: 27381786 DOI: 10.4045/tidsskr.15.1096] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Questionnaire surveys are important for surveying the health and disease behaviour of the population, but recent years have seen a fall in participation. Our study tested whether incentives can increase participation in these surveys.MATERIAL AND METHOD We sent a questionnaire on risk factors for colorectal cancer (height, weight, smoking, self-reported diagnoses, family medical history) to non-screened participants in a randomised colonoscopy screening study for colorectal cancer: participants who were invited but did not attend for colonoscopy examination (screening-invited) and persons who were not offered colonoscopy (control group). The persons were randomised to three groups: no financial incentive, lottery scratch cards included with the form, or a prize draw for a tablet computer when they responded to the form. We followed up all the incentive groups with telephone reminder calls, and before the prize draw for the tablet computer.RESULTS Altogether 3 705 of 6 795 persons (54.5 %) responded to the questionnaire; 43.5 % of those invited for screening and 65.6 % of the control group (p < 0.001). The proportion that answered was not influenced by incentives, either among those invited for screening (42.4 % in the non-prize group, 45.5 % in the lottery scratch card group and 42.6 % in the prize draw group; p = 0.24), or in the control group (65.6 % in the non-prize group, 66.4 % in the lottery scratch card group and 64.7 % in the prize draw group; p = 0.69). Prior to reminder calls, 39.2 % responded. A further 15.3 % responded following telephone reminder calls (14.1 % of the screening-invited and 16.5 % of the control group; p < 0.001).INTERPRETATION Incentives did not increase participation in this medical questionnaire survey. Use of telephone reminder calls and telephone interviews increased participation, but whether this is more effective than other methods requires further study.
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Affiliation(s)
| | - Anders Huitfeldt
- Avdeling for helseledelse og helseøkonomi Harvard TH Chan School of Public Health og Oslo universitetssykehus og Stanford University School of Medicine
| | - Magnus Løberg
- Avdeling for helseledelse og helseøkonomi Universitetet i Oslo og Avdeling for transplantasjonsmedisin og K.G. Jebsen senter for kolorektal cancer Oslo universitetssykehus
| | - Hans-Olov Adami
- Avdeling for helseledelse og helseøkonomi Universitetet i Oslo og Avdeling for transplantasjonsmedisin og K.G. Jebsen senter for kolorektal cancer Oslo universitetssykehus og Karolinska institutet og Harvard TH Chan School of Public Health
| | - Kjetil Garborg
- Avdeling for transplantasjonsmedisin Oslo universitetssykehus og Medisinsk avdeling Sørlandet sykehus Kristiansand
| | - Mette Kalager
- Avdeling for helseledelse og helseøkonomi Universitetet i Oslo og Avdeling for transplantasjonsmedisin og K.G. Jebsen senter for kolorektal cancer Oslo universitetssykehus
| | - Michael Bretthauer
- Avdeling for helseledelse og helseøkonomi Universitetet i Oslo og Avdeling for transplantasjonsmedisin og K.G. Jebsen senter for kolorektal cancer Oslo universitetssykehus og Sørlandet sykehus
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