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Rinta-Antila K, Koski P, Aira T, Heinonen OJ, Korpelainen R, Parkkari J, Savonen K, Toivo K, Uusitalo A, Valtonen M, Vasankari T, Villberg J, Kokko S. Perceived coaches' health promotion activity, maintenance of participation in sports, and lifestyle habits among emerging adults: a four-year follow-up study. Ann Med 2024; 56:2321327. [PMID: 38658832 DOI: 10.1080/07853890.2024.2321327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/15/2024] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVES This study focused on how adolescents' perceptions of coaches' health promotion activity predict maintained participation and dropout in organized sports in emerging adulthood. In addition, differences in lifestyle habits between maintainers, dropouts, and nonparticipants in organized sports were explored. MATERIALS AND METHODS Overall, 616 adolescents reported organized sports participation in the Finnish Health Promoting Sports Club (FHPSC) study at ages 15 and 19. Of these, 323 reported coach's health promotion activity on health topics at the age of 15. An index of a coach's general health promotion activity was formed. At age 19, all study participants reported their lifestyle habits. RESULTS Among males, those who had perceived coaches' general health promotion activity as frequent were more likely to be maintainers than dropouts (48.6% vs. 20.0%) (p = .002). Among females, there was no significant difference (32.0% vs. 28.4%). Logistic regression analysis adjusted for gender showed that perceiving coach's general health promotion activity as frequent increased the odds of being a maintainer rather than a dropout. Moreover, maintainers had higher odds of having healthy lifestyle habits when compared to nonparticipants (related to physical activity; sleep; fruit and vegetable consumption; and cigarette use) or dropouts (related to physical activity; and cigarette use). In addition, dropouts had higher odds of having healthy lifestyle habits than nonparticipants (related to sleep; and cigarette use). CONCLUSIONS Perceiving coaches' health promotion activity as frequent was related to maintained participation in organized sports among males. Maintainers were more likely to have more healthy lifestyle habits than nonparticipants and dropouts. There is a need to invest in coaches' health promotion activity when it is infrequent. A more detailed understanding is needed of coaches' health promotion activity that supports both maintained participation in sports, especially among females, and healthy lifestyle habits in emerging adulthood.
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Affiliation(s)
- Katja Rinta-Antila
- Faculty of Sport and Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, Jyväskylä, Finland
| | - Pasi Koski
- Department of Teacher Education, University of Turku, Rauma, Finland
| | - Tuula Aira
- Faculty of Sport and Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, Jyväskylä, Finland
| | - Olli J Heinonen
- Paavo Nurmi Centre & Unit for Health and Physical Activity, University of Turku, Turku, Finland
| | - Raija Korpelainen
- Medical Research Center (MRC), University of Oulu and University Hospital of Oulu, Oulu, Finland
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., Oulu, Finland
- Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - Jari Parkkari
- Faculty of Sport and Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, Jyväskylä, Finland
- Tampere Research Center of Sports Medicine, Tampere, Finland
| | - Kai Savonen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Kerttu Toivo
- Tampere Research Center of Sports Medicine, Tampere, Finland
| | - Arja Uusitalo
- Clinic for Sports and Exercise Medicine, Foundation for Sports and Exercise Medicine, Helsinki, Finland
- Department of Sports and Exercise Medicine, Clinicum, University of Helsinki, Helsinki, Finland
| | | | - Tommi Vasankari
- UKK Institute of Health Promotion Research, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jari Villberg
- Faculty of Sport and Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, Jyväskylä, Finland
| | - Sami Kokko
- Faculty of Sport and Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, Jyväskylä, Finland
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Heikkilä L, Korpelainen R, Aira T, Alanko L, Heinonen OJ, Kokko S, Parkkari J, Savonen K, Toivo K, Valtonen M, Vasankari T, Villberg J, Vanhala M. Is health promotion in sports clubs associated with adolescent participants' fruit and vegetable consumption? Eur J Public Health 2023; 33:1102-1108. [PMID: 37665763 PMCID: PMC10710333 DOI: 10.1093/eurpub/ckad158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Although sports clubs' potential for health promotion is acknowledged, research on whether they promote healthy eating is limited. We aimed to evaluate Finnish youth sports clubs' health promotion orientation, as well as associations between sports clubs' health promotion orientation, coaches' nutritional discussions and sports club participants' (SPs') fruit and/or vegetable consumption. METHODS The cross-sectional study included 554 SPs aged 14-16 years, 275 club officials and 311 coaches. Participants replied to questionnaires about sports clubs' health promotion and their own health behaviours, including dietary habits. Health promotion orientation was estimated using a Health Promoting Sports Club (HPSC) index (range 0-22) and nutritional discussions and fruit and/or vegetable consumption as frequencies. A mixed-effects multivariable logistic regression was used to analyse the associations. RESULTS Most sports clubs (69%) had a high health promotion orientation, but the variation between the clubs was wide (HPSC index range 5-21). SPs' daily fruit and/or vegetable consumption was associated with female gender [odds ratio (OR) 3.48, 95% confidence interval (CI) 2.23-5.42, P < 0.001], better self-rated health (OR 3.26, 95% CI 1.13-9.41, P = 0.03), higher average school grades (OR 1.67, 95% CI 1.04-2.67, P = 0.03), and SPs' responses that their coach had often discussed nutrition (OR 2.11, 95% CI 1.41-3.14, P < 0.001). CONCLUSION Although sports clubs' orientation towards health promotion was mostly high, it seems not to be enough to promote healthy eating among adolescent participants. Instead, coaches' nutritional discussions were associated with adolescents' fruit and/or vegetable consumption.
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Affiliation(s)
- Laura Heikkilä
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Raija Korpelainen
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Tuula Aira
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Lauri Alanko
- Sports Medicine Clinic, Foundation for Sports and Exercise Clinic, Helsinki, Finland
- Sports and Exercise Medicine Clinic, Central Finland Hospital Nova, Jyväskylä, Finland
| | - Olli J Heinonen
- Paavo Nurmi Centre & Unit for Physical Activity and Health, University of Turku, Turku, Finland
| | - Sami Kokko
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jari Parkkari
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Tampere Research Center of Sports Medicine, Tampere, Finland
| | - Kai Savonen
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Science Service Center, Kuopio University Hospital, Kuopio, Finland
| | - Kerttu Toivo
- Tampere Research Center of Sports Medicine, Tampere, Finland
- UKK Institute of Health Promotion Research, Tampere, Finland
| | - Maarit Valtonen
- Finnish Institute of High Performance Sports KIHU, Jyväskylä, Finland
| | - Tommi Vasankari
- UKK Institute of Health Promotion Research, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jari Villberg
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Marja Vanhala
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
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Aira T, Vasankari T, Heinonen OJ, Korpelainen R, Kotkajuuri J, Parkkari J, Savonen K, Toivo K, Uusitalo A, Valtonen M, Villberg J, Vähä-Ypyä H, Kokko SP. Psychosocial and health behavioural characteristics of longitudinal physical activity patterns: a cohort study from adolescence to young adulthood. BMC Public Health 2023; 23:2156. [PMID: 37924075 PMCID: PMC10625285 DOI: 10.1186/s12889-023-17122-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 11/01/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND The decline in physical activity (PA) during adolescence is well-established. However, while some subgroups of adolescents follow the general pattern of decreased activity, others increase or maintain high or low activity. The correlates and determinants of different PA patterns may vary, offering valuable information for targeted health promotion. This study aimed to examine how psychosocial factors, health behaviours, and PA domains are associated with longitudinal PA patterns from adolescence to young adulthood. METHODS This prospective study encompassed 254 participants measured at mean ages 15 and 19. Device-measured moderate-to-vigorous PA was grouped into five patterns (activity maintainers, inactivity maintainers, decreasers from moderate to low PA, decreasers from high to moderate PA, increasers) via a data-driven method, K-Means for longitudinal data. Multinomial logistic regression was used to analyse the associations between health behaviours, psychosocial factors, PA domains, and different PA patterns. RESULTS A lack of sports club participation characterised inactivity maintainers throughout adolescence. Difficulties in communicating with one's father at age 15 were associated with higher odds of belonging to inactivity maintainers and to decreasers from moderate to low PA. Lower fruit and vegetable consumption at age 19 was also related to increased odds of belonging to the groups of inactivity maintainers and decreasers from moderate to low PA. Smoking at age 19 was associated with being a decreaser from moderate to low PA. CONCLUSIONS Diverse factors characterise longitudinal PA patterns over the transition to young adulthood. Sports club participation contributes to maintained PA. Moreover, a father-adolescent relationship that supports open communication may be one determinant for sustained PA during adolescence. A healthier diet and non-smoking as a young adult are associated with more favourable PA development.
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Affiliation(s)
- Tuula Aira
- Faculty of Sport and Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, PL 35, Jyväskylä, FI-40014, Finland.
| | - Tommi Vasankari
- UKK Institute of Health Promotion Research, Kaupinpuistonkatu 1, FI-33500, Tampere, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Olli J Heinonen
- Paavo Nurmi Centre & Unit for Health and Physical Activity, University of Turku, Kiinamyllykatu 10, FI-20520, Turku, Finland
| | - Raija Korpelainen
- Medical Research Center (MRC), University of Oulu and University Hospital of Oulu, Oulu, Finland
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, P.O. Box 365, FI-90101, Oulu, Finland
- Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - Jimi Kotkajuuri
- Department of Mathematics and Statistics, University of Jyväskylä, P.O. Box 35, FI-40014, Jyväskylä, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, Kaupinpuistonkatu 1, FI-33500, Tampere, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, PL 35, FI-40014, Jyväskylä, Finland
| | - Kai Savonen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
- Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, FI-70100, Kuopio, Finland
| | - Kerttu Toivo
- Tampere Research Center of Sports Medicine, Kaupinpuistonkatu 1, FI-33500, Tampere, Finland
| | - Arja Uusitalo
- Clinic for Sports and Exercise Medicine, Foundation for Sports and Exercise Medicine, Mäkelänkatu 47, FI-00550, Helsinki, Finland
- Department of Sports and Exercise Medicine, University of Helsinki, Clinicum, Finland
| | - Maarit Valtonen
- Finnish Institute for High Performance Sport KIHU, Jyväskylä Finland, Rautpohjankatu 6, FI-40700, Jyväskylä, Finland
| | - Jari Villberg
- Faculty of Sport and Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, PL 35, Jyväskylä, FI-40014, Finland
| | - Henri Vähä-Ypyä
- UKK Institute of Health Promotion Research, Kaupinpuistonkatu 1, FI-33500, Tampere, Tampere, Finland
| | - Sami P Kokko
- Faculty of Sport and Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, PL 35, Jyväskylä, FI-40014, Finland
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Aira T, Kokko SP, Heinonen OJ, Korpelainen R, Kotkajuuri J, Parkkari J, Savonen K, Toivo K, Uusitalo A, Valtonen M, Villberg J, Niemelä O, Vähä-Ypyä H, Vasankari T. Longitudinal physical activity patterns and the development of cardiometabolic risk factors during adolescence. Scand J Med Sci Sports 2023; 33:1807-1820. [PMID: 37254479 DOI: 10.1111/sms.14415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 02/22/2023] [Accepted: 05/19/2023] [Indexed: 06/01/2023]
Abstract
PURPOSE To examine the associations between longitudinal physical activity (PA) patterns and the development of cardiometabolic risk factors from adolescence to young adulthood. METHODS This cohort study encompassed 250 participants recruited from sports clubs and schools, and examined at mean age 15 and 19. Device-measured moderate-to-vigorous PA was grouped into five patterns (via a data-driven method, using inactivity maintainers as a reference). The outcomes were: glucose, insulin, homeostasis model assessment for insulin resistance (HOMA-IR), total cholesterol, HDL and LDL cholesterol, triglycerides, blood pressure, and body mass index (BMI). Linear growth curve models were applied with adjustment for sex, age, fruit/vegetable consumption, cigarette/snuff use, and change in the device wear-time. RESULTS Insulin and BMI increased among decreasers from moderate to low PA (β for insulin 0.23, 95% CI 0.03-0.46; β for BMI 0.90; CI 0.02-1.78). The concentration of HDL cholesterol decreased (β -0.18, CI -0.31 to -0.05) and that of glucose increased (β 0.18, CI 0.02-0.35) among decreasers from high to moderate PA. By contrast, among increasers, blood pressure declined (systolic β -6.43, CI -12.16 to -0.70; diastolic β -6.72, CI -11.03 to -2.41). CONCLUSIONS Already during the transition to young adulthood, changes in PA are associated with changes in cardiometabolic risk factors. Favorable blood pressure changes were found among PA increasers. Unfavorable changes in BMI, insulin, glucose, and HDL cholesterol were found in groups with decreasing PA. The changes were dependent on the baseline PA and the magnitude of the PA decline.
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Affiliation(s)
- Tuula Aira
- Faculty of Sport and Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, Jyväskylä, Finland
| | - Sami Petteri Kokko
- Faculty of Sport and Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, Jyväskylä, Finland
| | - Olli Juhani Heinonen
- Paavo Nurmi Centre & Unit for Health and Physical Activity, University of Turku, Turku, Finland
| | - Raija Korpelainen
- Medical Research Center (MRC), University of Oulu and University Hospital of Oulu, Oulu, Finland
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., Oulu, Finland
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Jimi Kotkajuuri
- Department of Mathematics and Statistics, University of Jyväskylä, Jyväskylä, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, Tampere, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Kai Savonen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Kerttu Toivo
- Tampere Research Center of Sports Medicine, Tampere, Finland
| | - Arja Uusitalo
- Clinic for Sports and Exercise Medicine, Foundation for Sports and Exercise Medicine, Helsinki, Finland
- Department of Sports and Exercise Medicine, Clinicum, University of Helsinki, Helsinki, Finland
| | - Maarit Valtonen
- Research Institute for Olympic Sports, Jyväskylä Finland, Jyväskylä, Finland
| | - Jari Villberg
- Faculty of Sport and Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, Jyväskylä, Finland
| | - Onni Niemelä
- Medical Research Unit and Department of Laboratory Medicine, Seinäjoki Central Hospital and University of Tampere, Tampere, Finland
| | - Henri Vähä-Ypyä
- UKK Institute of Health Promotion Research, Tampere, Finland
| | - Tommi Vasankari
- UKK Institute of Health Promotion Research, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
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Boniel-Nissim M, Tynjälä J, Gobiņa I, Furstova J, van den Eijnden RJJM, Marino C, Klanšček HJ, Klavina-Makrecka S, Villeruša A, Lahti H, Vieno A, Wong SL, Villberg J, Inchley J, Gariépy G. Adolescent use of social media and associations with sleep patterns across 18 European and North American countries. Sleep Health 2023; 9:314-321. [PMID: 36804326 DOI: 10.1016/j.sleh.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 11/23/2022] [Accepted: 01/10/2023] [Indexed: 02/22/2023]
Abstract
OBJECTIVE Over the past decade, concurrent with increasing social media use (SMU), there has been a shift toward poorer sleep among adolescents in many countries. The purpose of this study was to examine the cross-national associations between adolescent SMU and sleep patterns, by comparing 4 different categories of SMU (nonactive, active, intense, and problematic use). DESIGN, SETTING, AND PARTICIPANTS Data were from 86,542 adolescents in 18 European and North American countries that participated in the 2017/18 Health Behaviour in School-aged study. MEASUREMENTS Mixed-effects linear regression models were used to examine cross-national associations between 4 SMU categories and adolescent sleep duration, bedtime and social jetlag derived from self-reported data. RESULTS For all countries combined, nonactive SMU was associated with longer sleep, earlier bedtimes, and less social jetlag, compared to active SMU, although the differences were minor. By comparison, intense and problematic SMU were associated with less sleep and later bedtimes on both school and nonschool days, and greater social jetlag, compared to active SMU. While findings were relatively consistent between countries, some differences were observed, suggesting that the national and cultural context may be important in interpreting results. CONCLUSIONS These findings suggest that both intense and problematic SMU are associated with poorer sleep patterns in adolescents across most countries. Further research is needed to identify effective policies, programs, and messaging to promote the healthy use of social media and prevent potential negative impacts on adolescent sleep.
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Affiliation(s)
- Meyran Boniel-Nissim
- Department of Educational Counselling, The Max Stern Academic College of Emek Yezreel, Emek Yezreel, Israel
| | - Jorma Tynjälä
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Inese Gobiņa
- Department of Public Health and Epidemiology, Institute of Public Health, Riga Stradins University, Riga, Latvia
| | - Jana Furstova
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
| | | | - Claudia Marino
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | | | | | - Anita Villeruša
- Department of Public Health and Epidemiology, Institute of Public Health, Riga Stradins University, Riga, Latvia
| | - Henri Lahti
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Alessio Vieno
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | - Suzy L Wong
- Public Health Agency of Canada, Ottawa, Canada
| | - Jari Villberg
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Joanna Inchley
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Geneviève Gariépy
- Public Health Agency of Canada, Ottawa, Canada; Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Canada.
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Mäkituomas L, Heikkilä L, Nurkkala M, Korpelainen R, Alanko L, Heinonen OJ, Kokko S, Kujala U, Parkkari J, Savonen K, Valtonen M, Vasankari T, Villberg J, Vanhala M. Factors associated with body size perception among adolescent goal-oriented sports participants and non-participants: a cross-sectional Finnish study. BMC Public Health 2022; 22:2188. [PMID: 36434562 PMCID: PMC9700987 DOI: 10.1186/s12889-022-14511-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/01/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Regardless of competitive athletes' body image pressures, only few studies have focused on adolescent sport participants' body image and the findings are inconclusive. Furthermore, the role of competitive goals in sports on adolescents' body size perception has not been studied. We examined the factors associated with adolescents' competitive goals in sports and body size perception, and the associations between adolescents' competitive goals in sports and body size perception. METHODS The cross-sectional study consisted of 475 goal-oriented sports club participants and 936 reference youths (aged 14-16 years). The study questionnaire included multiple choice items on health behaviours, motives to exercise, competitive goals in sports and body size perception. The multinomial logistic regression analysis was used to investigate the associations. RESULTS Adolescents with competitive goals in sports perceived their body size as about the right size more frequently than reference youths (68% vs 47%, p < 0.001 in girls; 74% vs 61%, p < 0.001 in boys). More than one-fourth of girls with competitive goals in sports perceived themselves as overweight, although only 7% of them were overweight. Adolescents with appearance/weight motives to exercise and poor perceived physical fitness had higher odds of perceived fatness. Additionally, BMI was positively associated with perceived fatness and negatively with perceived thinness. Having competitive goals in sports was not independently associated with perceived fatness or perceived thinness. CONCLUSIONS Adolescents' BMI, appearance/weight motives to exercise, and perceived physical fitness were more strongly associated with body size perception than their competitive goals in sports. However, perceived fatness among girls with competitive goals in sports should be considered in organized sports.
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Affiliation(s)
- Leevi Mäkituomas
- grid.417779.b0000 0004 0450 4652Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., P.O. Box 365, FI-90101 Oulu, Finland ,grid.10858.340000 0001 0941 4873Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland ,grid.10858.340000 0001 0941 4873Medical Research Center, University of Oulu and Oulu University Hospital, P.O. Box 8000, FI-90014 Oulu, Finland
| | - Laura Heikkilä
- grid.417779.b0000 0004 0450 4652Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., P.O. Box 365, FI-90101 Oulu, Finland ,grid.10858.340000 0001 0941 4873Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland ,grid.10858.340000 0001 0941 4873Medical Research Center, University of Oulu and Oulu University Hospital, P.O. Box 8000, FI-90014 Oulu, Finland
| | - Marjukka Nurkkala
- grid.417779.b0000 0004 0450 4652Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., P.O. Box 365, FI-90101 Oulu, Finland ,grid.10858.340000 0001 0941 4873Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland ,grid.10858.340000 0001 0941 4873Medical Research Center, University of Oulu and Oulu University Hospital, P.O. Box 8000, FI-90014 Oulu, Finland
| | - Raija Korpelainen
- grid.417779.b0000 0004 0450 4652Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., P.O. Box 365, FI-90101 Oulu, Finland ,grid.10858.340000 0001 0941 4873Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland ,grid.10858.340000 0001 0941 4873Medical Research Center, University of Oulu and Oulu University Hospital, P.O. Box 8000, FI-90014 Oulu, Finland
| | - Lauri Alanko
- Sports Medicine Clinic, Foundation for Sports and Exercise Clinic, Mäkelänkatu 47, FI-00550 Helsinki, Finland ,Sports and Exercise Medicine Clinic, Central Finland Hospital Nova, Hoitajantie 3, FI-40620 Jyväskylä, Finland
| | - Olli J. Heinonen
- grid.1374.10000 0001 2097 1371Paavo Nurmi Centre & Unit for Physical Activity and Health, University of Turku, Kiinamyllynkatu 10, FI-20520 Turku, Finland
| | - Sami Kokko
- grid.9681.60000 0001 1013 7965Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014 Jyväskylä, Finland
| | - Urho Kujala
- grid.9681.60000 0001 1013 7965Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014 Jyväskylä, Finland
| | - Jari Parkkari
- grid.9681.60000 0001 1013 7965Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014 Jyväskylä, Finland ,Tampere Research Center of Sports Medicine, Kaupinpuistonkatu 1, FI-33500 Tampere, Finland
| | - Kai Savonen
- grid.419013.eKuopio Research Institute of Exercise Medicine, Haapaniementie 16, FI-70100 Kuopio, Finland ,grid.410705.70000 0004 0628 207XDepartment of Clinical Physiology and Nuclear Medicine, Science Service Center, Kuopio University Hospital, P.O. Box 100, FI-70029 KYS, Kuopio, Finland
| | - Maarit Valtonen
- grid.419101.c0000 0004 7442 5933Research Institute for Olympic Sports, Rautpohjankatu 6, FI-40700 Jyväskylä, Finland
| | - Tommi Vasankari
- grid.415179.f0000 0001 0868 5401UKK Institute of Health Promotion Research, Kaupinpuistonkatu 1, FI-33500 Tampere, Finland ,grid.502801.e0000 0001 2314 6254Faculty of Medicine and Health Technology, Tampere University, Kalevantie 4, FI-33014 Tampere, Finland
| | - Jari Villberg
- grid.9681.60000 0001 1013 7965Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014 Jyväskylä, Finland
| | - Marja Vanhala
- grid.417779.b0000 0004 0450 4652Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., P.O. Box 365, FI-90101 Oulu, Finland ,grid.10858.340000 0001 0941 4873Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland ,grid.10858.340000 0001 0941 4873Medical Research Center, University of Oulu and Oulu University Hospital, P.O. Box 8000, FI-90014 Oulu, Finland
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Aira T, Vasankari T, Heinonen O, Korpelainen R, Parkkari J, Savonen K, Uusitalo A, Valtonen M, Villberg J, Kokko S. O9-1 Physical activity change and stability patterns from adolescence to early adulthood: how activity domains and sedentary behaviour are associated with maintaining, increasing and decreasing activity? Eur J Public Health 2022. [PMCID: PMC9435629 DOI: 10.1093/eurpub/ckac094.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Longitudinal studies demonstrate that physical activity (PA) declines on average from adolescence to early adulthood. However, some subgroups of adolescents increase activity while others decrease or maintain high or low activity. Determinants of change or maintenance of (in)activity may differ between subgroups and are valuable information for targeted health promotion. The purpose of this study was to identify PA patterns from adolescence to early adulthood, and also to explore how different activity domains and Sedentary Behaviour (SB) are associated with PA patterns. Methods The data of this observational cohort study (collected in 2013/2014 and 2017/2018) consisted of 254 Finns at age 15 and 19 participating the Health Promoting Sports Club study. K-means cluster analysis for longitudinal data was performed to identify participant clusters (patterns) based on their accelerometry-measured moderate-to-vigorous PA (MVPA). Associations of sports club participation (SC), active commuting (AC), and SB with PA patterns were examined by logistic regression analysis. Results (preliminary) Five MVPA patterns were identified: inactivity maintainers (n = 71), activity maintainers (n = 70), decreasers from moderate (to low) PA (n = 61), decreasers from high (to moderate) PA (n = 32), and increasers (n = 20). At age 15, SC participation (41-97%) and AC (47-75%) were common in all the patterns. By age 19, clear dropout from these activities was prevalent (SC participation mean 32%, AC 31-63%). Maintained SC participation was associated with a higher likelihood of belonging to the decreasers from high PA (OR = 11.2, CI = 1.4-90.0) and to the combined group of increasers and activity maintainers (OR = 3.6, CI = 1.8-7.4); also with a lower likelihood of being an inactivity maintainer (OR = 0.1, CI = 0.02-0.2). Dropout from SC was related to a higher likelihood of being a decreaser from high PA (OR = 10.9, CI = 1.3-90.7). Maintenance/adoption of AC was associated with a lower likelihood of being an inactivity maintainer (OR = 0.3, CI = 0.1-0.7). Decreased SB was related to a higher likelihood of belonging to the activity maintainers and increasers (OR = 0.96, CI = 0.93-0.98). Conclusions PA patterns diverge greatly over the transition to adulthood. Changes in SC participation, AC, and SB show different associations with diverging PA patterns. Hence, tailored PA promotion is recommended.
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Affiliation(s)
- Tuula Aira
- Faculty of Sports and Health Sciences, University of Jyväskylä , Jyväskylä, Finland
| | - Tommi Vasankari
- UKK Institute of Health Promotion Research , Tampere, Finland
| | - Olli Heinonen
- Paavo Nurmi centre & Unit for Health and Physical Activity, University of Turku , Turku, Finland
| | - Raija Korpelainen
- Medical Research Center (MRC), University of Oulu and University Hospital of Oulu , Oulu, Finland
- Center for Life Course Health Research, University of Oulu , Oulu, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine , Tampere, Finland
| | - Kai Savonen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital , Kuopio, Finland
- Kuopio Research Institute of Exercise Medicine , Kuopio, Finland
| | - Arja Uusitalo
- Clinic for Sports and Exercise Medicine, Foundation for Sports and Exercise Medicine , Helsinki, Finland
- Department of Sports and Exercise Medicine, Clinicum, University of Helsinki , Helsinki, Finland
| | | | - Jari Villberg
- Faculty of Sports and Health Sciences, University of Jyväskylä , Jyväskylä, Finland
| | - Sami Kokko
- Faculty of Sports and Health Sciences, University of Jyväskylä , Jyväskylä, Finland
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8
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Lyyra N, Junttila N, Tynjälä J, Villberg J, Välimaa R. Loneliness, subjective health complaints, and medicine use among Finnish adolescents 2006-2018. Scand J Public Health 2022; 50:1097-1104. [PMID: 36016473 DOI: 10.1177/14034948221117970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS Loneliness is an important public health challenge for all ages. This study reports time trends of loneliness among adolescents over a 12-year period and analyses the strength of the associations between loneliness, health complaints, and medicine use. METHODS Data were derived from the cross-sectional Finnish Health Behaviour in School-aged Children study conducted in 2006, 2010, 2014, and 2018. The study population is based on a random sample of schools with 20,444 participants aged 11-15 years. The trends were analysed with a Mantel-Haenszel test, and the strength of the associations was evaluated by mixed-effects logistic and linear regressions. RESULTS An increasing prevalence in frequent loneliness (2006: 11%; 2018: 15%) was evident over the 12-year study period, especially in girls and 15-year-olds. Among all adolescents, loneliness was associated with a higher risk of recurrent health complaints and medicine use to treat the corresponding health issues, especially nervousness (odds ratio 5.8) and sleeping difficulties (odds ratio 7.6). CONCLUSIONS Adolescence is a period of higher risk of frequent loneliness and associated health complaints. In this study, loneliness was common among adolescence and an increasing trend of loneliness was observed between 2006 and 2018. Also, psychosomatic health complaints and medicine use were strongly associated with loneliness. Persistent loneliness is a significant health risk and failure to resolve loneliness before entering adulthood may imply significant concerns for future well-being.
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Affiliation(s)
- Nelli Lyyra
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Niina Junttila
- Department of Teacher Education, University of Turku, Turku, Finland
| | - Jorma Tynjälä
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jari Villberg
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Raili Välimaa
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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9
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Toivo K, Vähä-Ypyä H, Kannus P, Tokola K, Alanko L, Heinonen OJ, Korpelainen R, Parkkari J, Savonen K, Selänne H, Kokko S, Kujala UM, Villberg J, Vasankari T. Physical activity measured by accelerometry among adolescents participating in sports clubs and non-participating peers. Eur J Sport Sci 2022:1-9. [PMID: 35861140 DOI: 10.1080/17461391.2022.2103740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AbstractThe purpose of this descriptive cross-sectional study is to describe the amount and intensity of physical activity (PA) measured by accelerometry among adolescents participating in organized sports (SCP) and age-matched non-participating peers (NP). SCPs (332) and NPs (139) wore an accelerometer on the hip for 7 days. PA was reported using the 1 min exponential moving average. The current moderate-to-vigorous physical activity (MVPA) recommendation of at least an average of 60 minutes of MVPA daily was reached by 85% of SCPs and 45% of NPs (p < 0.001). During training days, the MVPA times among SCPs ranged from 153 ± 39 min in males and 109 ± 35 min in females participating in basketball to 113 ± 33 min in males participating in floorball and 83 ± 32 min in females participating in gymnastics. -Sports participation contributes rather strongly to the accumulation of the recommended amount of MVPA. During training days SCPs, except for females participating in gymnastics, accumulated more MVPA than NPs. During non-training days only males participating in cross country skiing and females participating in track and field accumulated more MVPA than NPs.
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Affiliation(s)
- K Toivo
- Tampere Research Center of Sports Medicine, Tampere, Finland.,UKK Institute for Health Promotion Research, Tampere, Finland
| | - H Vähä-Ypyä
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - P Kannus
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - K Tokola
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - L Alanko
- Clinic for Sports and Exercise Medicine, Helsinki, Finland.,Central Finland Hospital, Jyväskylä, Finland
| | - O J Heinonen
- Paavo Nurmi Centre & Unit of Health and Physical Activity, University of Turku, Turku, Finland
| | - R Korpelainen
- Oulu Deaconess Institute Foundation sr., Department of Sports and Exercise Medicine, Oulu, Finland.,University of Oulu, Center for Life Course Health Research, Oulu, Finland.,Medical Research Center, University of Oulu and University Hospital of Oulu, Oulu, Finland
| | - J Parkkari
- Tampere Research Center of Sports Medicine, Tampere, Finland.,UKK Institute for Health Promotion Research, Tampere, Finland.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - K Savonen
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - H Selänne
- Department of Psychology, University of Jyväskylä
| | - S Kokko
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - U M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - J Villberg
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - T Vasankari
- UKK Institute for Health Promotion Research, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Finland
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Pentikäinen H, Toivo K, Kokko S, Alanko L, Heinonen OJ, Nylander T, Selänne H, Vasankari T, Kujala UM, Villberg J, Parkkari J, Savonen K. Resting Electrocardiogram and Blood Pressure in Young Athletes and Non-Athletes: A 4-year follow-up. Clin Physiol Funct Imaging 2022; 42:200-207. [PMID: 35180329 DOI: 10.1111/cpf.12747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 02/17/2022] [Indexed: 11/28/2022]
Abstract
A follow-up data on electrocardiogram (ECG) and blood pressure (BP) changes in adolescent athletes are scarce. We compared ECG and BP between adolescent athletes and non-athletes in a 4-year follow-up. A total of 154 youth sports clubs (SC) in Finland and 100 secondary schools for comparison data participated in this observational follow-up study. Those who maintained or adopted SC participation are referred to as "Always athletes" (n=137), those who never participated in SC as "Never athletes" (n=108) and those who dropped out of SC during the follow-up as "Changers" (n=116). The mean age of the participants was 15.5 (0.6) years in all study groups at baseline. Resting ECG including heart rate, PR interval, QRS duration, QRS axis, QRS amplitude, T axis and QT interval and BP were measured from all participants at baseline and after follow-up. "Always athletes" had lower resting heart rate, more negative T-wave axis and higher QRS amplitude than "Never athletes" at baseline and at 4-years (P < 0.05). "Changers" had lower resting heart rate, more negative T-wave axis and higher QRS amplitude, systolic BP and pulse pressure than "Never athletes" at baseline (P < 0.05). None of the observed differences at baseline, were visible at 4-years (P > 0.05) except the difference in T-wave axis (P = 0.028). The significant group x time interaction between "Changers" and "Never athletes" was found for QRS amplitude (P = 0.017). Adolescent athletes have several training-induced cardiovascular adaptations, which return towards the levels of non-athletes after cessation of regular training. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Heikki Pentikäinen
- Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, FI-70100, Kuopio, Finland
| | - Kerttu Toivo
- Tampere Research Center of Sports Medicine, Ukk Institute, Tampere, Finland.,UKK Institute for Health Promotion Research, Tampere, Finland
| | - Sami Kokko
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Lauri Alanko
- Clinic for Sports and Exercise Medicine, University of Helsinki, Helsinki, Finland.,Department of Sports and Exercise Medicine, Central Finland Central Hospital, Jyvaskyla, Finland
| | - Olli J Heinonen
- Paavo Nurmi Centre & Unit for Health and Physical Activity, University of Turku, Turku, Finland
| | - Tiina Nylander
- Department of Sports and Exercise Clinic, Oulu Deaconess Institute Foundation, Oulu, Finland
| | | | - Tommi Vasankari
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jari Villberg
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, Ukk Institute, Tampere, Finland.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Kai Savonen
- Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, FI-70100, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
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11
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Punna M, Lappalainen R, Kettunen T, Lappalainen P, Muotka J, Kaipainen K, Villberg J, Kasila K. Can peer-tutored psychological flexibility training facilitate physical activity among adults with overweight? Journal of Contextual Behavioral Science 2021. [DOI: 10.1016/j.jcbs.2021.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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12
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Aira T, Vasankari T, Heinonen OJ, Korpelainen R, Kotkajuuri J, Parkkari J, Savonen K, Uusitalo A, Valtonen M, Villberg J, Vähä-Ypyä H, Kokko SP. Physical activity from adolescence to young adulthood: patterns of change, and their associations with activity domains and sedentary time. Int J Behav Nutr Phys Act 2021; 18:85. [PMID: 34193150 PMCID: PMC8246658 DOI: 10.1186/s12966-021-01130-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 04/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Longitudinal studies demonstrate an average decline in physical activity (PA) from adolescence to young adulthood. However, while some subgroups of adolescents decrease activity, others increase or maintain high or low activity. Activity domains may differ between subgroups (exhibiting different PA patterns), and they offer valuable information for targeted health promotion. Hence, the aim of this study was to identify PA patterns from adolescence to young adulthood; also to explore the associations of (i) changes in PA domains and in sedentary time, (ii) sociodemographic factors, and (iii) self-rated health with diverging PA patterns. METHODS The observational cohort study data encompassed 254 adolescents at age 15 and age 19. K-means cluster analysis for longitudinal data was performed to identify participant clusters (patterns) based on their accelerometry-measured moderate-to-vigorous PA (MVPA). Logistic regressions were applied in further analysis. RESULTS Five PA patterns were identified: inactivity maintainers (n = 71), activity maintainers (n = 70), decreasers from moderate (to low) PA (n = 61), decreasers from high (to moderate) PA (n = 32), and increasers (n = 20). At age 15, participation in sports clubs (SC, 41-97%) and active commuting (AC, 47-75%) was common in all the patterns. By age 19, clear dropout from these activities was prevalent (SC participation mean 32%, AC 31-63%). Inactivity maintainers reported the lowest amount of weekly school physical education. Dropout from SC - in contrast to non-participation in SC - was associated with higher odds of being a decreaser from high PA, and with lower odds of being an inactivity maintainer. Maintained SC participation was associated with higher odds of belonging to the decreasers from high PA, and to the combined group of activity maintainers and increasers; also with lower odds of being an inactivity maintainer. Maintenance/adoption of AC was associated with decreased odds of being an inactivity maintainer. Self-reported health at age 19 was associated with the patterns of maintained activity and inactivity. CONCLUSIONS PA patterns diverge over the transition to adulthood. Changes in SC participation and AC show different associations with diverging PA patterns. Hence, tailored PA promotion is recommended.
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Affiliation(s)
- Tuula Aira
- Faculty of Sport and Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, PL 35, FI-40014, Jyväskylä, Finland.
| | - Tommi Vasankari
- UKK Institute of Health Promotion Research, Kaupinpuistonkatu 1, FI-33500, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Olli Juhani Heinonen
- Paavo Nurmi Centre & Unit for Health and Physical Activity, University of Turku, Kiinamyllykatu 10, FI-20520, Turku, Finland
| | - Raija Korpelainen
- Medical Research Center (MRC), University of Oulu and University Hospital of Oulu, Oulu, Finland
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, P.O. Box 365, FI-90101, Oulu, Finland
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Jimi Kotkajuuri
- Department of Mathematics and Statistics, University of Jyväskylä, P.O. Box 35, Jyväskylä, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, Kaupinpuistonkatu 1, FI-33500, Tampere, Finland
| | - Kai Savonen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
- Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, FI-70100, Kuopio, Finland
| | - Arja Uusitalo
- Clinic for Sports and Exercise Medicine, Foundation for Sports and Exercise Medicine, Alppikatu 2, FI-00530, Helsinki, Finland
- Department of Sports and Exercise Medicine, Clinicum, University of Helsinki, Helsinki, Finland
| | - Maarit Valtonen
- Research Center for Olympic Sports, Rautpohjankatu 6, FI-40700, Jyväskylä, Finland
| | - Jari Villberg
- Faculty of Sport and Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, PL 35, FI-40014, Jyväskylä, Finland
| | - Henri Vähä-Ypyä
- UKK Institute of Health Promotion Research, Kaupinpuistonkatu 1, FI-33500, Tampere, Finland
| | - Sami Petteri Kokko
- Faculty of Sport and Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, PL 35, FI-40014, Jyväskylä, Finland
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Lahti H, Lyyra N, Hietajärvi L, Villberg J, Paakkari L. Profiles of Internet Use and Health in Adolescence: A Person-Oriented Approach. Int J Environ Res Public Health 2021; 18:ijerph18136972. [PMID: 34209886 PMCID: PMC8296941 DOI: 10.3390/ijerph18136972] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/22/2021] [Accepted: 06/27/2021] [Indexed: 01/05/2023]
Abstract
(1) Background: Internet use has become an integral part of adolescents’ daily lives. It is important to understand how adolescents use the internet, and how this use is associated with demographic factors and health from a person-oriented perspective. (2) Methods: The study applied the Finnish nationally representative HBSC data (persons aged 11, 13, and 15, n = 3408), descriptive observation, latent class analysis, and multinomial logistic regression analysis. (3) Results: Entertainment activities (listening to music) and socially oriented activities (liking posts, talking online) were the most prevalent among adolescents, but gender differences emerged. Five different internet user profiles were identified (encompassing interest-driven, friendship-driven, abstinent, irregular, and excessive users). Interest-driven users participated in interest- and media-oriented activities. Adolescents in the interest-driven user group were more likely to be boys and participants with low academic achievement, high parental monitoring, and high problematic social media use. Friendship-driven users participated in socially oriented activities. Adolescents in the friendship-driven user group were more likely to be girls and participants aged 13 or 15, with high peer and family support. Abstinent users participated only in entertainment, while irregular users showed no particularly high involvement in any internet activity. Adolescents in the abstinent and irregular user groups were likely to be boys and participants aged 11 with high family support. Excessive users had high involvement in internet activities overall. Adolescents in the excessive user group were more likely to be participants with high problematic social media use and were most likely to feel low and tired on school mornings. (4) Conclusion: The study confirmed the prevalence of internet use. It identified five internet user profiles and differences between user profiles regarding individual and social factors and health outcomes.
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Heikkilä L, Korpelainen R, Aira T, Alanko L, Heinonen OJ, Kokko S, Kujala U, Parkkari J, Savonen K, Valtonen M, Vasankari T, Villberg J, Vanhala M. The associations between adolescents’ sports club participation and dietary habits. Transl Sports Med 2021. [DOI: 10.1002/tsm2.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Laura Heikkilä
- Department of Sports and Exercise Medicine Oulu Deaconess Institute Foundation sr. Oulu Finland
- Center for Life Course Health Research, Faculty of Medicine University of Oulu Oulu Finland
- Medical Research Center Oulu University Hospital and University of Oulu Oulu Finland
| | - Raija Korpelainen
- Department of Sports and Exercise Medicine Oulu Deaconess Institute Foundation sr. Oulu Finland
- Center for Life Course Health Research, Faculty of Medicine University of Oulu Oulu Finland
- Medical Research Center Oulu University Hospital and University of Oulu Oulu Finland
| | - Tuula Aira
- Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
| | - Lauri Alanko
- Sports Medicine Clinic Foundation for Sports and Exercise Clinic Helsinki Finland
- Sports and Exercise Medicine Clinic Central Finland Hospital Nova Jyväskylä Finland
| | - Olli J. Heinonen
- Paavo Nurmi Centre & Unit for Physical Activity and Health University of Turku Turku Finland
| | - Sami Kokko
- Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
| | - Urho Kujala
- Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine Tampere Finland
| | - Kai Savonen
- Kuopio Research Institute of Exercise Medicine Kuopio Finland
- Department of Clinical Physiology and Nuclear Medicine Kuopio University Hospital Kuopio Finland
| | | | - Tommi Vasankari
- UKK Institute of Health Promotion Research Tampere Finland
- Faculty of Medicine and Health Technology Tampere University Tampere Finland
| | - Jari Villberg
- Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
| | - Marja Vanhala
- Department of Sports and Exercise Medicine Oulu Deaconess Institute Foundation sr. Oulu Finland
- Center for Life Course Health Research, Faculty of Medicine University of Oulu Oulu Finland
- Medical Research Center Oulu University Hospital and University of Oulu Oulu Finland
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15
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Pentikäinen H, Toivo K, Kokko S, Alanko L, Heinonen OJ, Korpelainen R, Selänne H, Vasankari T, Kujala UM, Villberg J, Parkkari J, Savonen K. Resting Electrocardiogram and Blood Pressure in Young Endurance and Nonendurance Athletes and Nonathletes. J Athl Train 2021; 56:484-490. [PMID: 33150370 DOI: 10.4085/78-20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Much information is available on electrocardiogram (ECG) and blood pressure (BP) changes in senior athletes. However, corresponding data on adolescent athletes are scarce. OBJECTIVE To study the differences in resting ECG and BP values among adolescent endurance athletes, nonendurance athletes, and nonathletes. DESIGN Cross-sectional study. SETTING A total of 154 youth sports clubs in Finland and 100 secondary schools for comparison data. PATIENTS OR OTHER PARTICIPANTS We recruited young athletes (n = 410) aged 14 to 16 years in 10 popular sport disciplines, including winter and summer as well as team and individual sports, and categorized them as endurance or nonendurance sports. Comparison data for age-matched, non-sports club participants (n = 164) were collected via secondary schools. MAIN OUTCOME MEASURE(S) Resting ECG, including heart rate, PR interval, QRS duration, QRS axis, QRS amplitude, T axis, and QT interval as well as systolic and diastolic BPs. RESULTS No differences in any ECG variable of interest were found between the endurance and nonendurance athletes. The PR interval was longer in endurance athletes than in nonathletes (P = .05). The QRS amplitude (P = .03) was higher among nonendurance athletes than among nonathletes. Diastolic BP was lower among endurance (P = .002) and nonendurance (P = .02) athletes than among nonathletes. Endurance athletes (odds ratio [OR] = 2.85; 95% CI = 1.81, 4.50) and nonendurance athletes (OR = 2.19; 95% CI = 1.43, 3.35) were more likely to have sinus bradycardia than were nonathletes. Nonendurance athletes were more likely to have elevated systolic BP than were endurance athletes (OR = 1.70; 95% CI = 1.07, 2.72) and nonathletes (OR = 1.73; 95% CI = 1.04, 2.87). CONCLUSIONS Young athletes had similar ECG and BP findings independent of their sports. Physiological adaptations including sinus bradycardia, higher QRS amplitude, and lower diastolic BP, which are commonly seen in adult athletes, were also present in adolescent athletes.
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Affiliation(s)
| | - Kerttu Toivo
- Tampere Research Center of Sports Medicine, Finland
| | - Sami Kokko
- Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Lauri Alanko
- Clinic for Sports and Exercise Medicine, Helsinki, Finland
| | - Olli J Heinonen
- Paavo Nurmi Center & Unit of Health and Physical Activity University of Turku, Finland
| | - Raija Korpelainen
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute, Finland.,Center for Life Course Health Research, University of Oulu, Finland.,Medical Research Center, University of Oulu and University Hospital of Oulu, Finland
| | - Harri Selänne
- Department of Psychology, University of Jyväskylä, Finland
| | - Tommi Vasankari
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Jari Villberg
- Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, Finland.,UKK Institute for Health Promotion Research, Tampere, Finland
| | - Kai Savonen
- Kuopio Research Institute of Exercise Medicine, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Finland
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16
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Ravi S, Waller B, Valtonen M, Villberg J, Vasankari T, Parkkari J, Heinonen OJ, Alanko L, Savonen K, Vanhala M, Selänne H, Kokko S, Kujala UM. Menstrual dysfunction and body weight dissatisfaction among Finnish young athletes and non-athletes. Scand J Med Sci Sports 2020; 31:405-417. [PMID: 32979879 DOI: 10.1111/sms.13838] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 07/20/2020] [Accepted: 09/18/2020] [Indexed: 01/21/2023]
Abstract
To determine the prevalence of menstrual dysfunction (MD; ie, oligomenorrhea or amenorrhea) and attitudes toward body weight among athletes and non-athletes, we studied a cohort of athletes and non-athletes, in adolescence (14-16 years) and subsequently in young adulthood (18-20 years). We further studied the differences between athletes reporting MD and eumenorrheic athletes at both time periods and identified physical and behavioral characteristics that might predict MD in young adulthood. Data were collected using questionnaires, accelerometers, and a pre-participation screening. In adolescence, the athletes reported current primary amenorrhea more often than the non-athletes (4.7% vs 0%, P = .03). In young adulthood, athletes reported MD more frequently than non-athletes (38.7% vs 5.6%, P < .001). Athletes had less desire than non-athletes to lose weight at both time points, and in adolescence, athletes were more satisfied with their weight. However, about one fifth of the athletes and about 40% of the non-athletes experienced body weight dissatisfaction at both time points. In adolescence, athletes reporting MD had lower BMI than eumenorrheic athletes. In young adulthood, athletes with MD were more physically active than eumenorrheic athletes. The only longitudinal predictor of MD in young adulthood was MD in adolescence. Our findings indicate that MD is relatively frequent among young Finnish athletes. However, athletes appear to have a smaller tendency to experience body weight dissatisfaction than their non-athletic peers. MD seems to track from adolescence to adulthood, suggesting that there is a need to focus on possible causes at the earliest feasible phase of an athlete's career.
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Affiliation(s)
- Suvi Ravi
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Benjamin Waller
- Sports Science Department, School of Social Sciences, Physical Activity, Physical Education, Sport and Health Research Centre, Reykjavik University, Reykjavik, Iceland
| | | | - Jari Villberg
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Tommi Vasankari
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, Tampere, Finland
| | - Olli J Heinonen
- Paavo Nurmi Centre &Unit for Health and Physical Activity, University of Turku, Turku, Finland
| | - Lauri Alanko
- Sports Medicine Clinic, Foundation for Sports and Exercise Clinic, Helsinki, Finland.,Central Finland Central Hospital, Jyväskylä, Finland
| | - Kai Savonen
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Marja Vanhala
- Department of Sports and Exercise Clinic, Oulu Deaconess Institute Foundation sr, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center, University of Oulu and University Hospital of Oulu, Oulu, Finland
| | - Harri Selänne
- Faculty of Education and Psychology, Department of Psychology, University of Jyväskylä, Finland
| | - Sami Kokko
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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17
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Toivo K, Kannus P, Kokko S, Alanko L, Heinonen OJ, Korpelainen R, Savonen K, Selänne H, Vasankari T, Kannas L, Kujala UM, Villberg J, Niemelä O, Parkkari J. Haemoglobin, iron status and lung function of adolescents participating in organised sports in the Finnish Health Promoting Sports Club Study. BMJ Open Sport Exerc Med 2020; 6:e000804. [PMID: 33062301 PMCID: PMC7520547 DOI: 10.1136/bmjsem-2020-000804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2020] [Indexed: 02/06/2023] Open
Abstract
Objectives To compare laboratory test results and lung function of adolescent organised sports participants (SP) with non-participants (NP). Methods In this cross-sectional study, laboratory tests (haemoglobin, iron status), and flow-volume spirometry were performed on SP youths (199 boys, 203 girls) and their NP peers (62 boys, 114 girls) aged 14–17. Results Haemoglobin concentration <120/130 g/L was found in 5.8% of SP and 5.1% NP (OR 1.20, 95% CI 0.54 to 2.68). Ferritin concentration below 15 µg/L was found in 22.7% of both SP and NP girls. Among boys ferritin <30 µg/L was found in 26.5% of SP and 30.2% of NP (OR 0.76, 95% CI 0.40 to 1.47). Among SP iron supplement use was reported by 3.5% of girls and 1.5% of boys. In flow-volume spirometry with bronchodilation test, 7.0% of SP and 6.4% of NP had asthma-like findings (OR 1.17, 95% CI 0.54 to 2.54); those using asthma medication, that is, 9.8% of SP and 5.2% of NP were excluded from the analysis. Conclusions Screening for iron deficiency is recommended for symptomatic persons and persons engaging in sports. Lung function testing is recommended for symptomatic persons and persons participating in sports in which asthma is more prevalent.
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Affiliation(s)
- Kerttu Toivo
- Tampere Research Center of Sports Medicine, Ukk Institute, Tampere, Finland.,Ukk Institute for Health Promotion Research, Tampere, Finland
| | - Pekka Kannus
- Tampere Research Center of Sports Medicine, Ukk Institute, Tampere, Finland
| | - Sami Kokko
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Lauri Alanko
- Clinic for Sports and Exercise Medicine, Helsingin Yliopisto, Helsinki, Finland.,Department of Sports and Exercise Medicine, Central Finland Central Hospital, Jyvaskyla, Finland
| | - Olli J Heinonen
- Paavo Nurmi Centre & Unit for Health and Physical Activity, University of Turku, Turku, Finland
| | - Raija Korpelainen
- Department of Sports and Exercise Clinic, Oulu Deaconess Foundation, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center, University of Oulu and University Hospital of Oulu, Oulu, Finland
| | - Kai Savonen
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Harri Selänne
- Department of Psychology, University of Jyväskylä, Jyvaskyla, Finland
| | - Tommi Vasankari
- Ukk Institute for Health Promotion Research, Tampere, Finland
| | - Lasse Kannas
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Jari Villberg
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinajoki Central Hospital and University of Tampere, Seinajoki, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, Ukk Institute, Tampere, Finland.,Ukk Institute for Health Promotion Research, Tampere, Finland.,The Research Services, Tampere University Hospital, Tampere, Finland
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18
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Mehtälä A, Villberg J, Blomqvist M, Huotari P, Jaakkola T, Koski P, Lintunen T, Mononen K, Ng K, Palomäki S, Sääkslahti A, Tammelin T, Vasankari T, Kokko S. Individual- and environmental-related correlates of moderate-to-vigorous physical activity in 11-, 13-, and 15-year-old Finnish children. PLoS One 2020; 15:e0234686. [PMID: 32555590 PMCID: PMC7302665 DOI: 10.1371/journal.pone.0234686] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 06/02/2020] [Indexed: 11/26/2022] Open
Abstract
The objective of this study was to analyze the associations of various individual- and environmental-related factors with subgroups of daily, frequent, moderate and low moderate-to-vigorous physical activity (MVPA) among children and adolescents. Data were obtained from the Finnish School-age Physical Activity (FSPA) study 2016 from 4677 national representative 11-, 13-, and 15-year-old children and adolescents. MVPA and individual- and environmental-related factors were assessed by a questionnaire and analyzed by two-level logistic regression. Seventeen of the twenty-one variables were statistically significantly associated with MVPA. However, only three variables were statistically significant in all MVPA subgroups, whereby self-directed PA at least twice a week, fewer perceived barriers, and higher peer support increased the odds of participating in more MVPA. The results from this study showed essential differences among the MVPA subgroups, also supporting previous findings, whereby various individual- and environmental-based factors are associated with children and adolescents’ levels of MVPA. Challenges to designing and implementing effective interventions are based on the need to account for individual differences within the population, as well as the varied connections between PA with different social and physical environments where children and adolescents’ PA takes place. PA interventions with various actions at multiple levels are warranted.
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Affiliation(s)
- Anette Mehtälä
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
- * E-mail:
| | - Jari Villberg
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Minna Blomqvist
- KIHU – Research Institute for Olympic Sports, Jyväskylä, Finland
| | - Pertti Huotari
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Timo Jaakkola
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Pasi Koski
- Faculty of Education, University of Turku, Rauma, Finland
| | - Taru Lintunen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Kaisu Mononen
- KIHU – Research Institute for Olympic Sports, Jyväskylä, Finland
| | - Kwok Ng
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
- Department of Physical Education and Sport Sciences, Physical Activity for Health Research Cluster, University of Limerick, Limerick, Ireland
| | - Sanna Palomäki
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Arja Sääkslahti
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Tuija Tammelin
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Tommi Vasankari
- Urho Kaleva Kekkonen Institute for Health Promotion Research, Tampere, Finland
| | - Sami Kokko
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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19
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Paakkari L, Torppa M, Välimaa R, Villberg J, Ojala K, Tynjälä J. Health asset profiles and health indicators among 13- and 15-year-old adolescents. Int J Public Health 2019; 64:1301-1311. [PMID: 31297559 PMCID: PMC6868109 DOI: 10.1007/s00038-019-01280-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 10/31/2018] [Revised: 04/17/2019] [Accepted: 06/27/2019] [Indexed: 11/30/2022] Open
Abstract
Objectives We examined the associations between adolescents’ health assets and various health indicators (smoking, alcohol use, sleep length, physical activity, healthy eating, oral health, self-reported health, multiple health complaints). Methods A nationally representative sample was drawn from Finnish-speaking schools, comprising 13- and 15-year-old adolescents (n = 3833). The measures taken covered the adolescents’ health assets, which were labelled Family-financial, Psychological, Family-social, Friends-social, School-social, and Human. Our analysis applied two-step cluster analysis and multilevel mixed-effects binary logistic regression. Results Six asset profiles were identified: ‘Limited in most assets, despite medium affluence’, ‘Mostly average assets, but low affluence’, ‘Mostly average assets, though high affluence’, ‘Mostly above average assets’, ‘Rich in most assets’, and ‘Rich in all assets’. There were significant differences between the profiles in terms of risk level and desirable level health outcomes. Conclusions Adolescents differ in their asset profiles. Having multiple health assets appears to protect adolescents from risky behaviour or poor health, and to promote positive health. There is a need for health initiatives to develop a range of health-protecting and health-promoting assets, rather than focus on only one. Electronic supplementary material The online version of this article (10.1007/s00038-019-01280-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Leena Paakkari
- Research Center for Health Promotion, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L), 40014, Jyväskylä, Finland.
| | - Minna Torppa
- Department of Teacher Education, University of Jyväskylä, Jyväskylä, Finland
| | - Raili Välimaa
- Research Center for Health Promotion, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L), 40014, Jyväskylä, Finland
| | - Jari Villberg
- Research Center for Health Promotion, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L), 40014, Jyväskylä, Finland
| | - Kristiina Ojala
- Research Center for Health Promotion, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L), 40014, Jyväskylä, Finland
| | - Jorma Tynjälä
- Research Center for Health Promotion, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L), 40014, Jyväskylä, Finland
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20
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Ng K, Hämylä R, Tynjälä J, Villberg J, Tammelin T, Kannas L, Kokko S. Test-retest reliability of adolescents' self-reported physical activity item in two consecutive surveys. ACTA ACUST UNITED AC 2019; 77:9. [PMID: 30891238 PMCID: PMC6388478 DOI: 10.1186/s13690-019-0335-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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: 06/07/2018] [Accepted: 02/01/2019] [Indexed: 11/10/2022]
Abstract
Background National monitoring of school-aged physical activity (PA) behaviours is necessary to inform policy makers. The Finnish School-aged Physical Activity (FSPA – LIITU in Finnish) is a physical activity monitoring study, collecting data from young adolescents aged 11 to 15 years through a nationally representative sample. This study included a single self-reported item question on moderate to vigorous intensity physical activity (MVPA) from the preceding seven days. The question is used widely in the WHO Collaborative Cross-National Health Behaviour in School-aged Children (HBSC) study as a measure of meeting international PA recommendations. This study evaluated the test-retest reliability of the aforementioned MVPA item in two consecutive surveys while observing gender and age categorisation differences. Methods In this study, Finnish adolescents with mean ages of 11.5y, 13.5y and 15.5y (n = 2752) completed the HBSC and FSPA surveys in two 45 min class periods without a break in 2014. The HBSC survey completion mode was through pen and paper, and the FSPA study through a web-based questionnaire. The same MVPA question appeared in both surveys. Response alternatives (0–7 days per week) were grouped into four, and two categories in the analyses. Cohen’s Kappa and ICC statistics were performed to test the intra-rater test-retest reliability of the measure. Results According to Cohen’s Kappa, there was moderate agreement through the use of four (0.503) and two (0.599) categories, however, the proportion of adolescents that met the recommended daily 60 min of MVPA was 8% lower in the FSPA study than in the HBSC study (19% vs 27%). In addition, ICC for MVPA, as continuous variable (0–7 days) had good to excellent reliability (range 0.694–0.765) for boys and girls aged 13 to 15 years, but only fair (0.565) for boys aged 11. Conclusions This study demonstrated that single item MVPA item was considered to have acceptable reliability of the measure for monitoring purposes of 13- and 15-year old boys, and 11y-, 13- and 15y-old girls meeting the international PA recommendations. There were differences in the prevalence in daily MVPA due to survey design.
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Affiliation(s)
- Kwok Ng
- 1Research Centre of Health Promotion, Faculty of Sport and Health Sciences, University of Jyvaskyla, PO Box 35, 40014 Jyväskylä, Finland.,2Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland.,3School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
| | - Riikka Hämylä
- 1Research Centre of Health Promotion, Faculty of Sport and Health Sciences, University of Jyvaskyla, PO Box 35, 40014 Jyväskylä, Finland
| | - Jorma Tynjälä
- 1Research Centre of Health Promotion, Faculty of Sport and Health Sciences, University of Jyvaskyla, PO Box 35, 40014 Jyväskylä, Finland
| | - Jari Villberg
- 1Research Centre of Health Promotion, Faculty of Sport and Health Sciences, University of Jyvaskyla, PO Box 35, 40014 Jyväskylä, Finland
| | - Tuija Tammelin
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Lasse Kannas
- 1Research Centre of Health Promotion, Faculty of Sport and Health Sciences, University of Jyvaskyla, PO Box 35, 40014 Jyväskylä, Finland
| | - Sami Kokko
- 1Research Centre of Health Promotion, Faculty of Sport and Health Sciences, University of Jyvaskyla, PO Box 35, 40014 Jyväskylä, Finland
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21
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Ristolainen L, Toivo K, Parkkari J, Kokko S, Alanko L, Heinonen OJ, Korpelainen R, Savonen K, Selänne H, Vasankari T, Kannas L, Villberg J, Kujala UM. Acute and overuse injuries among sports club members and non-members: the Finnish Health Promoting Sports Club (FHPSC) study. BMC Musculoskelet Disord 2019; 20:32. [PMID: 30660197 PMCID: PMC6339310 DOI: 10.1186/s12891-019-2417-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 01/11/2019] [Indexed: 12/19/2022] Open
Abstract
Background Physical activity in adolescence is promoted for its multi-dimensional health benefits. However, too intensive sports participation is associated with an increased injury risk. Our aim was to compare the occurrence of acute and overuse injuries in Finnish sports club members and non-members and to report training and competing habits associated with a higher injury risk in sports club members. Methods In this cross-sectional survey targeted at 14–16-year-old adolescents, a structured questionnaire was completed by 1077 sports club members and 812 non-members. The main outcome measures were self-reported acute and overuse injuries, their location and type. Results At least one acute injury in the past year was reported by 44.0% of sports club members and 19.8% of non-members (P < 0.001). The sex-adjusted odds ratio (OR) for acute injury in sports club members compared to non-members was 3.13 (95% confidence interval (95% CI) 2.54–3.87). Thirty-five percent of sports club members and 17.4% of non-members (P < 0.001) reported at least one overuse injury during the past year. The overuse injury OR for sports club members was 2.61 (95% CI 2.09–3.26). Sports club members who trained 7–14 h per week during training (OR 1.61, 95% CI 1.21–2.12, P = 0.001) or competition season (OR 1.55, 95% CI 1.18–2.06, P = 0.002) were more likely to report an injury compared to members who trained 3–6 h per week. Those sports club members who participated in forty competitions or more compared to 7–19 competitions per year were more likely to report an acute injury (OR 1.55, 95% CI 1.05–2.08, P = 0.028) or for an overuse injury (OR 1.53, 95% CI 1.02–2.30, P = 0.038). Conclusions Both acute and overuse injuries are common among youth sports club members, and the number increases along with increasing amounts of training and competitions. More effective injury prevention is needed both for adolescents engaging in sports club activities and for other adolescents. Electronic supplementary material The online version of this article (10.1186/s12891-019-2417-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- L Ristolainen
- Orton Orthopaedic Hospital, Orton, Helsinki, Finland.
| | - K Toivo
- Tampere Research Center of Sports Medicine, Tampere, Finland
| | - J Parkkari
- Tampere Research Center of Sports Medicine, Tampere, Finland
| | - S Kokko
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - L Alanko
- Sports Medicine Clinic, Foundation for Sports and Exercise Clinic, Helsinki, Finland
| | - O J Heinonen
- Paavo Nurmi Centre & Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - R Korpelainen
- Oulu Deaconess Institute, Department of Sports and Exercise Medicine, Oulu, Finland.,Medical Research Center Oulu Oulu University Hospital and University of Oulu, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - K Savonen
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - H Selänne
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - T Vasankari
- UKK Institute of Health Promotion Research, Tampere, Finland
| | - L Kannas
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - J Villberg
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - U M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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22
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Ng KW, Rintala P, Husu P, Villberg J, Vasankari T, Kokko S. Device-based physical activity levels among Finnish adolescents with functional limitations. Disabil Health J 2019; 12:114-120. [DOI: 10.1016/j.dhjo.2018.08.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 08/22/2018] [Accepted: 08/31/2018] [Indexed: 11/16/2022]
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23
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Gobina I, Villberg J, Välimaa R, Tynjälä J, Whitehead R, Cosma A, Brooks F, Cavallo F, Ng K, de Matos MG, Villerusa A. Prevalence of self-reported chronic pain among adolescents: Evidence from 42 countries and regions. Eur J Pain 2018; 23:316-326. [DOI: 10.1002/ejp.1306] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 08/07/2018] [Accepted: 08/07/2018] [Indexed: 11/05/2022]
Affiliation(s)
- Inese Gobina
- Department of Public Health and Epidemiology; Institute of Public Health; Rīga Stradinš University; Rīga Latvia
| | - Jari Villberg
- Faculty of Sport and Health Sciences; University of Jyväskylä; Jyväskylä Finland
| | - Raili Välimaa
- Faculty of Sport and Health Sciences; University of Jyväskylä; Jyväskylä Finland
| | - Jorma Tynjälä
- Faculty of Sport and Health Sciences; University of Jyväskylä; Jyväskylä Finland
| | | | - Alina Cosma
- Child and Adolescent Health Research Unit (CAHRU); School of Medicine; University of St Andrews; St Andrews UK
| | - Fiona Brooks
- Faculty of Health; University of Technology Sydney; Ultimo New South Wales Australia
| | - Franco Cavallo
- Department of Public Health and Paediatrics; School of Medicine; University of Torino; Torino Italy
| | - Kwok Ng
- Physical Education and Sport Sciences Department; University of Limerick; Limerick Ireland
| | | | - Anita Villerusa
- Department of Public Health and Epidemiology; Institute of Public Health; Rīga Stradinš University; Rīga Latvia
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24
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Kokko S, Martin L, Geidne S, Van Hoye A, Lane A, Meganck J, Scheerder J, Seghers J, Villberg J, Kudlacek M, Badura P, Mononen K, Blomqvist M, De Clercq B, Koski P. Does sports club participation contribute to physical activity among children and adolescents? A comparison across six European countries. Scand J Public Health 2018; 47:851-858. [PMID: 29999480 DOI: 10.1177/1403494818786110] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Aims: Insufficient physical activity (PA) is one of the largest public health challenges of our time and requires a multisectoral public-health response. PA recommendations state that all children and adolescents should accumulate at least 60 minutes of moderate-to-vigorous PA (MVPA) daily and carry out vigorous PA (VPA) three times weekly. While participation in sports club activities is known to enhance the probability of reaching the recommended overall PA level, less is known about the contribution of sports club participation to VPA, and few cross-national comparisons have been carried out. The purpose of this paper is to study whether participation in sports club activities is associated with meeting the overall PA and VPA recommendations among children and adolescents across six European countries, namely Belgium (Flanders), Czech Republic, Finland, France, Ireland and Sweden. Methods: Analyses were carried out on existing self-reported national data sets using descriptive statistics and logistic regression. Results: Results indicate that approximately two-thirds of children and adolescents take part in sports club activities in the given countries. Sports club participants were more likely to meet the overall PA recommendations (OR 2.4-6.4) and VPA recommendation (OR 2.8-5.0) than non-participants. Conclusions: The extent to which overall PA and/or VPA is gained through sports club participation versus other settings needs to be further studied. Nonetheless, it can be argued that sports clubs have an important position in PA promotion for younger populations.
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Affiliation(s)
- Sami Kokko
- Research Centre for Health Promotion, University of Jyväskylä, Finland
| | - Leena Martin
- Research Centre for Health Promotion, University of Jyväskylä, Finland
| | | | | | - Aoife Lane
- Department of Sport and Health Science, Athlone Institute of Technology, Ireland
| | - Jeroen Meganck
- Department of Movement Sciences, Physical Activity, Sports & Health Research Group, KU Leuven - University of Leuven, Belgium
| | - Jeroen Scheerder
- Department of Movement Sciences, Policy in Sports & Physical Activity Research Group, KU Leuven - University of Leuven, Belgium
| | - Jan Seghers
- Department of Movement Sciences, Physical Activity, Sports & Health Research Group, KU Leuven - University of Leuven, Belgium
| | - Jari Villberg
- Research Centre for Health Promotion, University of Jyväskylä, Finland
| | - Michal Kudlacek
- Department of Recreation and Leisure Studies, Palacký University, Czech Republic
| | - Petr Badura
- Faculty of Physical Culture, Palacký University, Czech Republic
| | - Kaisu Mononen
- KIHU - Research Institute for Olympic Sports, Finland
| | | | - Bart De Clercq
- Faculty of Medicine and Health Sciences, Ghent University, Belgium
| | - Pasi Koski
- Department of Teacher Education, University of Turku, Finland
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25
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Toivo K, Kannus P, Kokko S, Alanko L, Heinonen OJ, Korpelainen R, Savonen K, Selänne H, Vasankari T, Kannas L, Kujala UM, Villberg J, Parkkari J. Musculoskeletal examination in young athletes and non-athletes: the Finnish Health Promoting Sports Club (FHPSC) study. BMJ Open Sport Exerc Med 2018; 4:e000376. [PMID: 29955377 PMCID: PMC6018865 DOI: 10.1136/bmjsem-2018-000376] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 04/04/2018] [Accepted: 04/04/2018] [Indexed: 12/26/2022] Open
Abstract
Objectives To determine the inter-rater repeatability of a musculoskeletal examination and to compare findings between adolescent athletes and non-athletes in Finland. Methods In this cross-sectional study, a musculoskeletal examination assessing posture, mobility and movement control was carried out by a sports and exercise medicine physician on 399 athletes aged 14–17 years and 177 non-athletes. Within 2 weeks another sports and exercise medicine physician repeated the examination for 41 adolescents to test the inter-rater repeatability. Results In total, 10 of the 11 tests performed had at least moderate inter-rater reliability (κ ≥0.4 or percentage agreement >80%). Athletes more often than non-athletes had one shoulder protruded (8.0% vs 4.0%, OR 2.81, 95% CI 1.16 to 6.81). Forty-six per cent of athletes had good knee control in the two-legged vertical drop jump test compared with 32% of non-athletes (OR 1.99, 95% CI 1.29 to 3.06). Athletes had better core muscle control with 86.3% being able to remain in the correct plank position for 30 s compared with 68.6% of non-athletes (OR 2.70, 95% CI 1.67 to 4.36). In the deep squat test, good lumbar spine control was maintained only by 35.8% of athletes and 38.4% of non-athletes. Conclusion A basic musculoskeletal examination is sufficiently reliable to be performed by trained physicians as a part of a periodic health evaluation. Shortfalls in mobility, posture and movement control are common in both athletes and non-athletes. These deficits could have been caused by sedentary behaviour, monotonous training, or both.
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Affiliation(s)
- Kerttu Toivo
- Tampere Research Center of Sports Medicine, Tampere, Finland.,UKK Institute for Health Promotion Research, Tampere, Finland
| | - Pekka Kannus
- Tampere Research Center of Sports Medicine, Tampere, Finland.,UKK Institute for Health Promotion Research, Tampere, Finland
| | - Sami Kokko
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Lauri Alanko
- Clinic for Sports and Exercise Medicine, Helsinki, Finland
| | - Olli J Heinonen
- Paavo Nurmi Centre & Unit of Health and Physical Activity, University of Turku, Turku, Finland
| | - Raija Korpelainen
- Department of Sports and Exercise Clinic, Oulu Deaconess Institute, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center, University of Oulu and University Hospital of Oulu, Oulu, Finland
| | - Kai Savonen
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Harri Selänne
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Tommi Vasankari
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Lasse Kannas
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jari Villberg
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, Tampere, Finland.,UKK Institute for Health Promotion Research, Tampere, Finland
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26
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Räisänen AM, Kokko S, Pasanen K, Leppänen M, Rimpelä A, Villberg J, Parkkari J. Prevalence of adolescent physical activity-related injuries in sports, leisure time, and school: the National Physical Activity Behaviour Study for children and Adolescents. BMC Musculoskelet Disord 2018; 19:58. [PMID: 29448928 PMCID: PMC5815200 DOI: 10.1186/s12891-018-1969-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 02/08/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to investigate the prevalence of adolescent physical activity-related injuries in sports club activities, leisure time physical activity and school-based physical activity. The secondary aim was to investigate the differences in the prevalence of physical activity -related injuries between years 2014 and 2016. In addition, we set out to study the associations between age, sex and the frequency of physical activity and injury prevalence. METHODS This cross-sectional study is based on the National Physical Activity Behaviour Study for Children and Adolescents (LIITU in Finnish) conducted in years 2014 and 2016. The subjects completed an online questionnaire in the classroom during school hours. A total of 8406 subjects participated in the current study. Out of these, 49% were boys and 51% were girls. The proportions of 11-, 13-, and 15-year-olds were 35%, 34% and 31%, respectively. RESULTS In the combined data for 2014 and 2016, injury prevalence was higher in sports club activities (46%, 95% CI 44.8-47.8) than in leisure time PA (30%, 95% CI, 28.5-30.5) or school-based PA (18%, 95% CI, 17.4-19.1). In leisure time PA, the injury prevalence was higher than in school-based PA. In all the three settings, injury prevalence was higher in 2016 than in 2014. Frequency of PA was associated with a higher risk for PA-related injuries in sports clubs and leisure time. CONCLUSIONS With half of the subjects reporting at least one PA-related injury during the past year, results indicate that adolescent PA-related injuries are a large-scale problem. There is a worrisome rise in injury prevalence in recent years. From a public health standpoint, there is an urgent need to invest in injury prevention to reverse this trend.
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Affiliation(s)
- Anu M Räisänen
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, P.O. BOX 30, 33501, Tampere, Finland.
| | - Sami Kokko
- Research Center for Health Promotion, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Kati Pasanen
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, P.O. BOX 30, 33501, Tampere, Finland.,Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Mari Leppänen
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, P.O. BOX 30, 33501, Tampere, Finland
| | - Arja Rimpelä
- Faculty of Social Sciences, Health Sciences and PERLA (Tampere Centre for Childhood, Youth and Family Research), University of Tampere, Tampere, Finland.,Department of Adolescent Psychiatry, Tampere University Hospital, Tampere, Finland
| | - Jari Villberg
- Research Center for Health Promotion, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, P.O. BOX 30, 33501, Tampere, Finland
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Mehtala MA, Saakslahti A, Soini A, Tammelin T, Kulmala J, Villberg J, Nissinen K, Poskiparta M. The effect of the cluster randomized HIPPA intervention on childcare children’s overall physical activity. BJHPA 2017. [DOI: 10.29359/bjhpa.09.4.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Nuutinen T, Lehto E, Ray C, Roos E, Villberg J, Tynjälä J. Clustering of energy balance-related behaviours, sleep, and overweight among Finnish adolescents. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx186.275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- T Nuutinen
- Folkhälsan Research Center, Helsinki, Finland
| | - E Lehto
- Folkhälsan Research Center, Helsinki, Finland
| | - C Ray
- Folkhälsan Research Center, Helsinki, Finland
| | - E Roos
- Folkhälsan Research Center, Helsinki, Finland
| | - J Villberg
- University of Jyväskylä, Jyväskylä, Finland
| | - J Tynjälä
- University of Jyväskylä, Jyväskylä, Finland
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29
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Kokko S, Donaldson A, Geidne S, Seghers J, Scheerder J, Meganck J, Lane A, Kelly B, Casey M, Eime R, Villberg J, Kannas L. Piecing the puzzle together: case studies of international research in health-promoting sports clubs. Glob Health Promot 2017; 23:75-84. [PMID: 27199020 DOI: 10.1177/1757975915601615] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Accepted: 06/24/2015] [Indexed: 11/16/2022]
Abstract
This paper seeks to review the current international health-promoting sports club (HPSC) research, drawing together findings based on case studies from various countries to illustrate the status of HPSCs. In addition, future challenges for HPSC research and implementation are considered. The review includes six case studies from five countries. In summary, there are two major research themes in this area, namely 'research into HPSC activity' and 'research into HPSC networks'. The first theme investigates the extent to which sports clubs and/or national sports organisations invest in health promotion (HP) - both in policy and practice. The latter theme is driven by an intention to widen the scope of HPSCs to reach novel internal actors, like parents, siblings, etc., and/or external non-sporting bodies, like communities, schools, etc. The future challenges for HPSC research require a better understanding of the motives, barriers and capacities of sports clubs and coaches. Sports organisations, clubs and coaches generally support the intent of the HPSC concept, but even with the best evidence- or theory-based HP programmes/guidelines/standards, nothing will happen in practice if the nature and capacities of sports clubs are not better acknowledged. Therefore, a call for embracing implementation science is finally made to enhance implementation.
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Affiliation(s)
- Sami Kokko
- Research Centre for Health Promotion, Department of Health Sciences, University of Jyvaskyla, Finland
| | - Alex Donaldson
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Australia
| | - Susanna Geidne
- School of Health and Medical Sciences, Örebro University, Sweden
| | - Jan Seghers
- Physical Activity, Sports & Health Research Group, Department of Kinesiology, KU Leuven - University of Leuven, Belgium
| | - Jeroen Scheerder
- Policy in Sports & Physical Activity Research Group, Department of Kinesiology, KU Leuven - University of Leuven, Belgium
| | - Jeroen Meganck
- Physical Activity, Sports & Health Research Group, Department of Kinesiology, KU Leuven - University of Leuven, Belgium
| | - Aoife Lane
- Centre for Health Behaviour Research, Department of Health, Sport and Exercise Science, Waterford Institute of Technology, Ireland
| | - Bridget Kelly
- Early Start Research Institute, University of Wollongong, Australia
| | - Meghan Casey
- School of Health Sciences and Psychology, Federation University Australia, Ballarat, Australia
| | - Rochelle Eime
- School of Health Sciences and Psychology, Federation University Australia, Ballarat, Australia Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Australia
| | - Jari Villberg
- Research Centre for Health Promotion, Department of Health Sciences, University of Jyvaskyla, Finland
| | - Lasse Kannas
- Research Centre for Health Promotion, Department of Health Sciences, University of Jyvaskyla, Finland
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30
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Paakkari L, Kokko S, Villberg J, Paakkari O, Tynjälä J. Health literacy and participation in sports club activities among adolescents. Scand J Public Health 2017; 45:854-860. [DOI: 10.1177/1403494817714189] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Aims: The aim of this research was to compare the levels of perceived health literacy among adolescents who do or do not participate in sports club activities. Organized sport club activities reach a high proportion of adolescents, and have the potential to contribute to the development of their health literacy. Methods: The cross-sectional data on health literacy among school children in Finland (aged 13 and 15, n=3852) were measured, as a part of the Health Behaviour in School-Aged Children (HBSC) study, using the Health Literacy for School-aged Children (HLSAC) instrument. Sports club participation and its association with health literacy were examined in relation to age, gender, family affluence, school achievement, and physical activity. The statistical analyses included cross-tabulation and the multilevel mixed-effects logistic regression analyses. Results: Perceived health literacy was higher among adolescents who participated in sports club activities. This conclusion was valid for boys and girls, for both age groups, among those who were physically active 6–7 days a week, had at least moderate school achievement, and those who belonged to the middle or high affluence families. From the health literacy perspective, participation in sports club activities was especially beneficial for those having low or moderate school achievement level. Conclusions: The sports club setting may work towards equalizing health literacy differences related to school achievement. However, the clubs should ensure that access is available to as many adolescents as possible; by this means they may spread beneficial influences, supporting the development of health literacy among broader population groups.
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Affiliation(s)
- Leena Paakkari
- Faculty of Sport and Health Sciences, Research Center for Health Promotion, University of Jyväskylä, Finland
| | - Sami Kokko
- Faculty of Sport and Health Sciences, Research Center for Health Promotion, University of Jyväskylä, Finland
| | - Jari Villberg
- Faculty of Sport and Health Sciences, Research Center for Health Promotion, University of Jyväskylä, Finland
| | - Olli Paakkari
- Faculty of Sport and Health Sciences, Research Center for Health Promotion, University of Jyväskylä, Finland
| | - Jorma Tynjälä
- Faculty of Sport and Health Sciences, Research Center for Health Promotion, University of Jyväskylä, Finland
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31
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Liu Y, Lintonen T, Tynjälä J, Villberg J, Välimaa R, Ojala K, Kannas L. Socioeconomic differences in the use of alcohol and drunkenness in adolescents: Trends in the Health Behaviour in School-aged Children study in Finland 1990-2014. Scand J Public Health 2016; 46:102-111. [PMID: 29468953 DOI: 10.1177/1403494816684118] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS The aims of this study were to explore time-based trends of socioeconomic differences in alcohol use and drunkenness in Finnish adolescents from 1990 to 2014 and to investigate the significance of two indicators in detecting socioeconomic differences in alcohol use and drunkenness. METHODS Data were retrieved from seven surveys conducted as part of the Health Behaviour in School-aged Children (HBSC) study in Finland from 1990 to 2014. The alcohol use and drunkenness of 15-year-old students, as well as socioeconomic status, including educational aspiration and perceived family wealth, were assessed via a self-report questionnaire. Logistic regression models were used to investigate the relationships between alcohol use, drunkenness and indicators of socioeconomic status. RESULTS The study showed that the alcohol use and drunkenness of Finnish 15-year-old adolescents have decreased since the late 1990s. However, the level of decrease is not consistent among different socioeconomic groups and socioeconomic differences in drinking behaviour between two educational aspiration groups have persisted over two decades. Girls from the groups with low perceived family wealth were more likely to be frequently drunk in the time period 2006-2014. CONCLUSIONS This study suggests that students with low educational aspiration should be the target population for interventions aiming at reducing the alcohol use and drunkenness of Finnish adolescents. In future interventions aimed at reducing heavier drinking, adolescents (especially girls) from less wealthy families should be the first priority. Further studies on trends in socioeconomic differences in alcohol use and drunkenness in adolescence should be conducted using different indicators of socioeconomic status and other social context factors should also be taken into account.
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Affiliation(s)
- Yang Liu
- 1 School of Physical Education and Sport Training, Shanghai University of Sport, China.,2 Shanghai Research Center for Physical Fitness and Health of Children and Adolescents, Shanghai University of Sport, China
| | | | - Jorma Tynjälä
- 4 Research Center for Health Promotion, Department of Health Sciences, University of Jyvaskyla, Finland
| | - Jari Villberg
- 4 Research Center for Health Promotion, Department of Health Sciences, University of Jyvaskyla, Finland
| | - Raili Välimaa
- 4 Research Center for Health Promotion, Department of Health Sciences, University of Jyvaskyla, Finland
| | - Kristiina Ojala
- 4 Research Center for Health Promotion, Department of Health Sciences, University of Jyvaskyla, Finland
| | - Lasse Kannas
- 4 Research Center for Health Promotion, Department of Health Sciences, University of Jyvaskyla, Finland
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Liu Y, Wang M, Tynjälä J, Villberg J, Lv Y, Kannas L. Socioeconomic differences in adolescents' smoking: a comparison between Finland and Beijing, China. BMC Public Health 2016; 16:805. [PMID: 27534849 PMCID: PMC4989516 DOI: 10.1186/s12889-016-3476-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 08/10/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Various studies have demonstrated the associations between socioeconomic status (SES) and health and health behaviour among adolescents. However, few studies have compared the socioeconomic difference in adolescent smoking between countries with different stage of smoking. The purpose of this study was to examine and compare the relationship between socioeconomic status (SES) and adolescent smoking in Beijing, China and Finland through the Health Behaviour in School-aged Children (HBSC) study. METHODS The data used in this study were derived from the Chinese HBSC linked project survey 2008 in Beijing and the Finnish HBSC survey 2006. The final sample included 2005 Chinese and 1685 Finnish 15-year-old schoolchildren. The associations between Family Affluence Scale (FAS), as the SES measure, and adolescents' smoking behaviour, including ever smoked, weekly smoking and the early onset of smoking were examined separately in two countries through binary logistic regression. RESULTS Compared to students from the high FAS group, Chinese boys from the low FAS group were more likely to report having ever smoked (OR = 2.12, 95 % CI = 1.49-3.01) and being early onset of smoking (OR = 2.17, 95 % CI = 1.44-3.26). Finnish girls from the low FAS group were more likely to report being weekly smokers (OR = 1.68, 95 % CI = 1.07-2.65). No significant difference was found for Chinese girls and Finnish boys. CONCLUSIONS This study indicated different patterns of socioeconomic difference in smoking between Chinese and Finnish adolescents by gender and by smoking behaviour, which suggests that socioeconomic inequalities in smoking are different among adolescents in countries with different stage of smoking. Country specific policies and interventions for different target groups should be encouraged and designed for reducing the prevalence of adolescents' smoking.
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Affiliation(s)
- Yang Liu
- School of Physical Education and Sport Training, Shanghai University of Sport, 200438, Shanghai, China. .,Shanghai Research Centre for Physical Fitness and Health of Children and Adolescents, Shanghai University of Sport, 200438, Shanghai, China.
| | - Mei Wang
- Mass Sport Research Centre, China Institute of Sport Science, 100061, Beijing, China
| | - Jorma Tynjälä
- Research Centre for Health Promotion, Department of Health Sciences, University of Jyvaskyla, 40014, Jyväskylä, Finland
| | - Jari Villberg
- Research Centre for Health Promotion, Department of Health Sciences, University of Jyvaskyla, 40014, Jyväskylä, Finland
| | - Yan Lv
- Zhejiang Institute of Sport Science, 310004, Hangzhou, China
| | - Lasse Kannas
- Research Centre for Health Promotion, Department of Health Sciences, University of Jyvaskyla, 40014, Jyväskylä, Finland
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Pellinen T, Villberg J, Raappana M, Leino-Kilpi H, Kettunen T. Knowledge expectations of recently diagnosed patients with knee osteoarthritis. J Adv Nurs 2016; 72:2857-2868. [DOI: 10.1111/jan.13053] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2016] [Indexed: 02/06/2023]
Affiliation(s)
- Tiina Pellinen
- Department of Health Sciences; University of Jyväskylä; Finland
| | - Jari Villberg
- Department of Health Sciences; University of Jyväskylä; Finland
| | | | - Helena Leino-Kilpi
- Department of Nursing Science; University of Turku; Finland
- Turku University Hospital; Turku Finland
| | - Tarja Kettunen
- Department of Health Sciences; University of Jyväskylä; Finland
- Central Finland Health Care District; Jyväskylä Finland
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Rossi M, Pasanen K, Kokko S, Alanko L, Heinonen OJ, Korpelainen R, Savonen K, Selänne H, Vasankari T, Kannas L, Kujala U, Villberg J, Parkkari J. Low back and neck and shoulder pain in members and non-members of adolescents' sports clubs: the Finnish Health Promoting Sports Club (FHPSC) study. BMC Musculoskelet Disord 2016; 17:263. [PMID: 27370945 PMCID: PMC4930616 DOI: 10.1186/s12891-016-1114-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 06/02/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The objective of this study was to investigate the prevalence of self-reported low back pain (LBP) and neck and shoulder pain (NSP), and the related factors in members and non-members of adolescents' sports clubs. METHODS This cross-sectional study was based on surveys of 14-16-year-olds as a part of the Finnish Health Promoting Sports Club (FHPSC) Study. The surveys on self-reported health behaviours, injuries, and musculoskeletal health were conducted among sports club members (n = 962) and non-members (n = 675). Binary logistic regression analysis was applied to study the associations between dependent variables of LBP and NSP, and the independent factors. RESULTS The prevalence of LBP during the preceding 3 months was 35.0 % in girls and 24.5 % in boys (p < 0.05 for sex difference). The prevalence of NSP was 55.9 % in girls and 27.3 % in boys (p < 0.001 for sex difference). Being a sports club member increased the odds for LBP in boys (odds ratio [OR] 2.35, 95 % CI 1.48-3.72). On the other hand, sports club participation was associated with lower odds of frequent NSP in girls (OR 0.52, 95 % CI 0.33-0.82). No associations were found between other leisure-time physical activity and LBP or NSP. Higher screen time (computer games, TV/DVD, phone, Internet) during leisure-time increased the odds of NSP in boys and LBP in boys and girls. CONCLUSIONS In this study, self-reported LBP and NSP were already relatively common among adolescents. Girls have a higher risk for reporting LBP and NSP. Measures that are more effective in the prevention of LBP in male sports club members are needed. Excessive screen time is weakly associated with LBP and NSP, which should be taken into account in health promotion among adolescents.
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Affiliation(s)
- M Rossi
- Tampere Research Center of Sports Medicine, P.O. Box 30, FI-33501, Tampere, Finland.
| | - K Pasanen
- Tampere Research Center of Sports Medicine, P.O. Box 30, FI-33501, Tampere, Finland.,UKK Institute for Health Promotion Research, P.O. Box 30, FI-33501, Tampere, Finland
| | - S Kokko
- Department of Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014, Jyväskylä, Finland
| | - L Alanko
- Clinic for Sports and Exercise Medicine, Alppikatu 2, FI-00530, Helsinki, Finland
| | - O J Heinonen
- Paavo Nurmi Centre & Department of Health and Physical Activity, University of Turku, Kiinamyllynkatu 10, FI-20520, Turku, Finland
| | - R Korpelainen
- Department of Sports and Exercise Clinic, Oulu Deaconess Institute, Albertinkatu 18, FI-90100, Oulu, Finland.,University of Oulu, Center for Life Course Health Research, Oulu, Finland.,Medical Research Center, University of Oulu and University Hospital of Oulu, Oulu, Finland
| | - K Savonen
- Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, FI-70100, Kuopio, Finland
| | - H Selänne
- LIKES Foundation for Sports and Health Sciences and Mehiläinen Physical Activity Clinic, P.O. Box 35, FI-40720, Jyväskylä, Finland
| | - T Vasankari
- UKK Institute for Health Promotion Research, P.O. Box 30, FI-33501, Tampere, Finland
| | - L Kannas
- Department of Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014, Jyväskylä, Finland
| | - U Kujala
- Department of Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014, Jyväskylä, Finland
| | - J Villberg
- Department of Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014, Jyväskylä, Finland
| | - J Parkkari
- Tampere Research Center of Sports Medicine, P.O. Box 30, FI-33501, Tampere, Finland.,UKK Institute for Health Promotion Research, P.O. Box 30, FI-33501, Tampere, Finland
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35
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Mäkelä K, Kokko S, Kannas L, Villberg J, Vasankari T, Heinonen JO, Savonen K, Alanko L, Korpelainen R, Selänne H, Parkkari J. Physical Activity, Screen Time and Sleep among Youth Participating and Non-Participating in Organized Sports—The Finnish Health Promoting Sports Club (FHPSC) Study. ACTA ACUST UNITED AC 2016. [DOI: 10.4236/ape.2016.64038] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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36
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Kokko S, Selänne H, Alanko L, Heinonen OJ, Korpelainen R, Savonen K, Vasankari T, Kannas L, Kujala UM, Aira T, Villberg J, Parkkari J. Health promotion activities of sports clubs and coaches, and health and health behaviours in youth participating in sports clubs: the Health Promoting Sports Club study. BMJ Open Sport Exerc Med 2015; 1:e000034. [PMID: 27900129 PMCID: PMC5117060 DOI: 10.1136/bmjsem-2015-000034] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [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] [Accepted: 08/18/2015] [Indexed: 01/22/2023] Open
Abstract
Introduction Sports clubs form a potential setting for health promotion, but the research is limited. The aim of the Health Promoting Sports Club (HPSC) study was to elucidate the current health promotion activities of youth sports clubs and coaches, and to investigate the health behaviours and health status of youth participating in sports clubs compared to non-participants. Methods and analysis The study design employs cross-sectional multilevel and multimethod research with aspirations to a prospective cohort study in the next phase. The setting-based variables at sports clubs and coaching levels, and health behaviour variables at the individual level, are investigated using surveys; and total levels of physical activity are assessed using objective accelerometer measurements. Health status variables will be measured by preparticipation screening. The health promotion activity of sports clubs (n=154) is evaluated by club officials (n=313) and coaches (n=281). Coaches and young athletes aged 14–16 (n=759) years evaluate the coaches’ health promotion activity. The survey of the adolescents’ health behaviours consist of two data sets—the first is on their health behaviours and the second is on musculoskeletal complaints and injuries. Data are collected via sports clubs (759 participants) and schools 1650 (665 participants and 983 non-participants). 591 (418 athletes and 173 non-athletes) youth, have already participated in preparticipation screening. Screening consists of detailed personal medical history, electrocardiography, flow-volume spirometry, basic laboratory analyses and health status screening, including posture, muscle balance, and static and dynamic postural control tests, conducted by sports and exercise medicine specialists. Ethics and dissemination The HPSC study is carried out conforming with the declaration of Helsinki. Ethical approval was received from the Ethics Committee of Health Care District of Central Finland. The HPSC study is close-to-practice, which generates foundations for development work within youth sports clubs.
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Affiliation(s)
- Sami Kokko
- Department of Health Sciences , Research Center for Health Promotion, University of Jyvaskyla , Jyväskylä , Finland
| | - Harri Selänne
- LIKES Foundation for Sport and Health Sciences and Mehiläinen Sports Clinic , Jyväskylä , Finland
| | - Lauri Alanko
- Clinic of Sports and Exercise Medicine, Foundation for Sport and Exercise Medicine , Helsinki , Finland
| | - Olli J Heinonen
- Paavo Nurmi Centre and Department of Physical Activity & Health , University of Turku , Turku , Finland
| | - Raija Korpelainen
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute, Oulu, Finland; University of Oulu, Centre for Life Course Epidemiology and Systems Medicine, Oulu, Finland; Medical Research Center, University of Oulu and University Hospital of Oulu, Oulu, Finland
| | - Kai Savonen
- Kuopio Research Institute of Exercise Medicine , Kuopio , Finland
| | - Tommi Vasankari
- UKK Institute of Health Promotion Research , Tampere , Finland
| | - Lasse Kannas
- Department of Health Sciences , Research Center for Health Promotion, University of Jyvaskyla , Jyväskylä , Finland
| | - Urho M Kujala
- Department of Health Sciences , Research Center for Health Promotion, University of Jyvaskyla , Jyväskylä , Finland
| | - Tuula Aira
- Department of Health Sciences , Research Center for Health Promotion, University of Jyvaskyla , Jyväskylä , Finland
| | - Jari Villberg
- Department of Health Sciences , Research Center for Health Promotion, University of Jyvaskyla , Jyväskylä , Finland
| | - Jari Parkkari
- UKK Institute of Health Promotion Research, Tampere, Finland; Tampere Research Center of Sports Medicine, Tampere, Finland
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Wold B, Littlecott H, Tynjälä J, Samdal O, Moore L, Roberts C, Kannas L, Villberg J, Aarø LE. Changes from 1986 to 2006 in reasons for liking leisure-time physical activity among adolescents. Scand J Med Sci Sports 2015. [PMID: 26220306 DOI: 10.1111/sms.12528] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Reasons for participating in physical activity (PA) may have changed in accordance with the general modernization of society. The aim is to examine changes in self-reported reasons for liking leisure-time physical activity (LTPA) and their association with self-reported LTPA over a 20-year period. Data were collected among nationally representative samples of 13-year-olds in Finland, Norway, and Wales in 1986 and 2006 (N = 9252) as part of the WHO cross-national Health Behaviour in School-aged Children (HBSC) study. Univariate ANOVAs to establish differences according to gender, year, and country were conducted. In all countries, 13-year-olds in 2006 tended to report higher importance in terms of achievement and social reasons than their counterparts in 1986, while changes in health reasons were minor. These reasons were associated with LTPA in a similar way at both time points. Health reasons for liking LTPA were considered most important, and were the strongest predictor of LTPA. The findings seem robust as they were consistent across countries and genders. Health education constitutes the most viable strategy for promoting adolescents' motivation for PA, and interventions and educational efforts could be improved by an increased focus on LTPA and sport as a social activity.
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Affiliation(s)
- B Wold
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | - H Littlecott
- DECIPHer UKCRC Public Health Research Centre of Excellence, Cardiff University, Cardiff, UK
| | - J Tynjälä
- Department of Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, Jyväskylä, Finland
| | - O Samdal
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | - L Moore
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - C Roberts
- Social Research and Information Division, Welsh Government, Cardiff, UK
| | - L Kannas
- Department of Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, Jyväskylä, Finland
| | - J Villberg
- Department of Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, Jyväskylä, Finland
| | - L E Aarø
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway.,Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway
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Kronholm E, Puusniekka R, Jokela J, Villberg J, Urrila AS, Paunio T, Välimaa R, Tynjälä J. Trends in self-reported sleep problems, tiredness and related school performance among Finnish adolescents from 1984 to 2011. J Sleep Res 2014; 24:3-10. [PMID: 25367818 DOI: 10.1111/jsr.12258] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 10/04/2014] [Indexed: 01/20/2023]
Abstract
The aim of this study was to investigate long-term trends in insomnia symptoms, tiredness and school performance among Finnish adolescents. A time-series from 1984 to 2011 was analysed from two large-scale survey studies, the Finnish School Health Promotion Study and the Health Behavior in School-Aged Children study. A total of 1,136,583 adolescents aged 11-18 years answered a standardized questionnaire assessing frequency of insomnia symptoms, tiredness and school performance. A clear approximately twofold increasing trend in insomnia symptoms and tiredness was found from the mid-1990s to the end of the 2000s. The increase was evident in all participating age groups and in both genders. After 2008, the increase seems to have stopped. Insomnia symptoms and tiredness were associated with lower school performance and they were more prevalent among girls (11.9 and 18.4%) compared to boys (6.9 and 9.0%, respectively). Unexpectedly, we also observed an increasingly widening gap in school performance between normally vigilant and chronically tired pupils. The underlying causes of these phenomena are unknown, but may concern changes in the broader society. The observed recent increasing trend in adolescents' sleep problems is worrisome: poor sleep quality has also been suggested to associate with clinical or subclinical mood or anxiety disorders and behavioural problems and predispose to sleep and psychiatric disorders later in life. Our results justify further studies and call for serious attention to be paid to adolescent's sleep in the Finnish educational system and society at large.
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Affiliation(s)
- Erkki Kronholm
- National Institute for Health and Welfare, Turku, Finland
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Vähäsarja K, Salmela S, Villberg J, Rintala P, Vanhala M, Saaristo T, Peltonen M, Keinänen-Kiukaanniemi S, Korpi-Hyövälti E, Moilanen L, Niskanen L, Oksa H, Poskiparta ME. Perceived sufficiency of physical activity levels among adults at high risk of type 2 diabetes: the FIN-D2D study. Int J Behav Med 2014; 21:99-108. [PMID: 23224617 DOI: 10.1007/s12529-012-9285-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Any increase from a low level of physical activity reduces the risk of type 2 diabetes. However, lack of awareness of one's physical activity level insufficiency may act as an obstacle to increased physical activity. PURPOSE This study assessed the determinants of perceived physical activity levels (PALs) among adults at high risk of diabetes and the associations with self-reported physical activity. METHODS In total, 10,149 adults participated in the FIN-D2D lifestyle intervention at baseline. Opportunistic screening was used in identifying high-risk individuals. Physical activity and perceived PAL sufficiency were assessed and compared. Key risk factors for diabetes and psychosocial and demographic characteristics were analyzed as determinants using logistic regression. RESULTS PAL sufficiency was rated realistically by 73 % of men and 75 % of women. Perception of sufficient PAL was more likely among individuals with a smaller waist circumference, a higher level of perceived fitness, and no exercise intention. In men, a higher age, and in women, a lower education, and a lower occupational status, also increased the likelihood of perceiving PAL as sufficient. Out of all the participants, 65 % of men and 66 % of women were inactive. Among the inactive participants, 20 (men) and 16 % (women) overestimated their PAL sufficiency. In both genders, such overestimation was predicted by dyslipidemia, a lower waist circumference, a higher level of perceived fitness, and no exercise intention; also (among men) by a higher age and a family history of diabetes, and (among women) by a lower occupational status, and a lower BMI. CONCLUSIONS In diabetes prevention, it is important to recognize the groups that perceive their PAL as sufficient since they may not see increased PAL as a tool for decreasing their risk of diabetes.
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Affiliation(s)
- Kati Vähäsarja
- Research Centre for Health Promotion, Department of Health Sciences, University of Jyväskylä, 40014, Jyväskylä, Finland,
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Gobina I, Villberg J, Villerusa A, Välimaa R, Tynjälä J, Ottova-Jordan V, Ravens-Sieberer U, Levin K, Cavallo F, Borraccino A, Sigmund E, Andersen A, Holstein BE. Self-reported recurrent pain and medicine use behaviours among 15-year olds: results from the international study. Eur J Pain 2014; 19:77-84. [PMID: 24807819 DOI: 10.1002/ejp.524] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND There is considerable variation in adolescent pain prevalence across epidemiological studies, with limited information on pain-related behaviours among adolescents, including medicine use. The aims of this study were (1) to examine the prevalence of recurrent pain among 15-year-old adolescents internationally; (2) to investigate the association between recurrent pain and medicine use behaviours among boys and girls; and (3) to evaluate the consistency of these associations across countries. METHODS The World Health Organization (WHO) collaborative international Health Behaviour in School-aged Children 2009/2010 study collects data about self-reported aches and medicine use from 36,762 15-year-old adolescents from 22 countries/regions in Europe and the United States. Multi-level multivariate logistic regression, stratified by gender, was used to analyse the association between recurrent pain and medicine use for headache, stomachache, nervousness and difficulties in getting to sleep. RESULTS More than 30% of adolescents reported recurrent headache, almost 30% recurrent backache and approximately 20% recurrent stomachache. Although pain prevalence and medicine use for aches were much higher for girls, the association between pain and medicine use was similarly strong for both genders. Adolescents with recurrent pain are more likely to use medicines also for non-corresponding pain, nervousness and difficulties in getting to sleep. The association between recurrent pain and medicine use was consistent across countries despite large-country differences in the prevalence of recurrent pain and medicine use. CONCLUSIONS Recurrent pain in adolescence is common cross-nationally. Adolescents with recurrent pain are more likely to use medicine in general. Recurrent pain and medicine use should be addressed in adolescent health policies.
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Affiliation(s)
- I Gobina
- Department of Public Health and Epidemiology, Riga Stradins University, Latvia
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Kaasalainen KS, Kasila K, Villberg J, Komulainen J, Poskiparta M. A cross-sectional study of low physical fitness, self-rated fitness and psychosocial factors in a sample of Finnish 18- to 64-year-old men. BMC Public Health 2013; 13:1113. [PMID: 24289531 PMCID: PMC4219528 DOI: 10.1186/1471-2458-13-1113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 11/26/2013] [Indexed: 11/25/2022] Open
Abstract
Background The biological risk factors of inactivity and poor cardiorespiratory fitness are well established. However, risk groups are hard to reach and they may have misperceptions of their need for change. This study explored self-ratings of physical fitness (PF) and the relationship between objectively estimated physical fitness (PFI) and psychosocial factors among Finnish men of working-age. Methods Cross-sectional data on 899 Finnish men (aged 18–64) were collected in 2011. Health- related physical fitness was evaluated with a physical fitness index calculated from the results of selected fitness tests. The men were subsequently classified into three groups: low, moderate and high PFI. Psychosocial factors and self-rated fitness were elicited in the questionnaire. The data were analysed with crosstabulations, chi square-test and logistic regression analysis. Results One-fifth of the participants had low PFI. Forty-five per cent of the low-fit middle-aged (35–49 years) men self-reported poor PF, while 80 per cent of the younger (18–34 years) low-fit men self-reported moderate or good PF. The health benefits and recommended dose of physical activity were well known in all the PFI categories. The low-fit men were health conscious, but lacked adequate exercise skills, self-efficacy and social support. However, logistic regressions revealed that, in the younger men, likelihood of better knowledge was not related to higher PFI. Among the 50-to-64-year-old men, high PFI was not associated with a higher social support. Conclusions Poor exercise skills, self-efficacy and social support were related to low PFI. Physical activity promotion for low-fit men should take into account age differences in the relationship between psychosocial factors and physical fitness. Thus, new and effective ways to establish social support and motivation for physical activity among low-fit men in all working-age groups are needed. Further research is also warranted on whether estimation of PFI could be used as a practical health counselling tool.
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Affiliation(s)
- Karoliina S Kaasalainen
- Faculty of Sport and Health Sciences, University of Jyväskylä, P,O,Box 35 (L) FI-40014, Jyväskylä, Finland.
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Vähäsarja K, Salmela S, Villberg J, Rintala P, Vanhala M, Saaristo T, Peltonen M, Keinänen-Kiukaanniemi S, Korpi-Hyövälti E, Kujala UM, Moilanen L, Niskanen L, Oksa H, Poskiparta M. Perceived need to increase physical activity levels among adults at high risk of type 2 diabetes: a cross-sectional analysis within a community-based diabetes prevention project FIN-D2D. BMC Public Health 2012; 12:514. [PMID: 22781026 PMCID: PMC3506518 DOI: 10.1186/1471-2458-12-514] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 06/21/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Increased physical activity is a cornerstone of type 2 diabetes prevention. The perception of a need to change is considered essential in behaviour change processes. However, the existing literature on individuals' perceived need to change health behaviour is limited. In order to improve understanding of diabetes prevention through increased physical activity levels (PAL), we assessed factors associated with perceiving a need to increase PAL among adults at high risk of diabetes. METHODS Opportunistic screening was used within a primary-care based lifestyle intervention covering 10 149 men and women at high risk of type 2 diabetes. Data were obtained at baseline visits. The explored determinants were demographic, anthropometric/clinical, behavioural and psychosocial characteristics, along with four categories of PAL awareness. Logistic regression was used in the analysis. RESULTS 74% of men (n = 2 577) and 76% of women (n = 4 551) perceived a need to increase their PAL. The participants most likely to perceive this need were inactive, had a larger waist circumference, rated their PAL as insufficient, and were at the contemplation stage of change. Smoking, elevated blood pressure, dyslipidaemia, and a family history of diabetes were not associated with this perception. The likelihood was also greater among women with less perceived fitness and less education. Demographic factors other than education did not determine participants' perceived need to increase PAL. PAL overestimators were less likely to perceive the need to increase their PAL than realistic inactive participants. CONCLUSIONS Subjective rather than objective health factors appear to determine the perception of a need to increase PAL among adults at high risk of diabetes. Client perceptions need to be evaluated in health counselling in order to facilitate a change in PAL. Practical descriptions of the associations between metabolic risk factors, PAL, and diabetes are needed in order to make the risk factors concrete for at-risk individuals.
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Affiliation(s)
- Kati Vähäsarja
- Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
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Salmela SM, Vähäsarja K, Villberg J, Vanhala M, Saaristo T, Lindström J, Oksa H, Korpi-Hyövälti E, Niskanen L, Keinänen-Kiukaanniemi S, Poskiparta M. The reporting of previous lifestyle counseling by persons at high risk of Type 2 diabetes. Patient Educ Couns 2012; 87:178-185. [PMID: 21943790 DOI: 10.1016/j.pec.2011.08.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2011] [Revised: 08/01/2011] [Accepted: 08/26/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To assess (i) whether the reporting of counseling previously received is associated with high-risk individuals' agreement to participate in lifestyle intervention, (ii) whether the reporting of previous counseling differed within such a high-risk group, and (iii) the associations between lifestyles and previous lifestyle counseling. METHODS Cross-sectional data were drawn from 10149 adults at high risk of Type 2 diabetes, who were participating in a Finnish national diabetes prevention project (FIN-D2D). Bivariate analysis and multivariate logistic regression were used. RESULTS In relation to the reporting of previous counseling, no difference was found between persons who had agreed and persons who had not agreed to participate in the lifestyle intervention. Persons who were more educated or who had dyslipidemia or diabetes were more likely than the others to report previous counseling. A generally healthy lifestyle, or certain health behaviors (being a non-smoker or eating large amounts of fruit and vegetables) may make the reporting of previous counseling more likely. CONCLUSION The results raise questions about the amount and quality of the previously received lifestyle counseling. PRACTICE IMPLICATIONS There is a need for sustainable lifestyle counseling structures, within vigorously implemented diabetes prevention projects, if long-lasting lifestyle changes are to be achieved.
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Affiliation(s)
- Sanna M Salmela
- Research Centre for Health Promotion, Faculty of Sport and Health Sciences, Department of Health Sciences, University of Jyväskylä, Finland.
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Ojala K, Tynjälä J, Välimaa R, Villberg J, Kannas L. Overweight Adolescents' Self-Perceived Weight and Weight Control Behaviour: HBSC Study in Finland 1994-2010. J Obes 2012; 2012:180176. [PMID: 22690329 PMCID: PMC3368427 DOI: 10.1155/2012/180176] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Revised: 02/15/2012] [Accepted: 03/26/2012] [Indexed: 11/18/2022] Open
Abstract
Introduction. Overweight and perception of being overweight, may lead adolescent to lose weight. The aim of the present study was to investigate overweight adolescents' self-perceived weight, body dissatisfaction, and weight control behaviour during 1994-2010 in Finland. Methods. The country-representative, cross-sectional data of 15-year olds were obtained from the Health Behaviour in School-aged Children (HBSC) study, conducted in 1994 (N = 1194; males: 48%), 1998 (N = 1545; 49%), 2002 (N = 1745; 50%), 2006 (N = 1670; 47%), and 2010 (N = 2082; 48%). Results. The majority of overweight boys (62-69%) and girls (89-100%) assessed themselves as too fat, and their body image was lower than in nonoverweight adolescents. The highest prevalence of current weight controlling was found in 2006 in males (18%) and in 2010 in females (39%). Conclusion. The phenomena were current and gender differences notable, but there was no statistically significant difference in overweight adolescents' self-perceived weight, body dissatisfaction, or weight control behaviour between survey years.
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Affiliation(s)
- Kristiina Ojala
- Department of Health Sciences, Research Center for Health Promotion, University of Jyväskylä, P.O. Box 35, 40014 Jyväskylä, Finland
- *Kristiina Ojala:
| | - Jorma Tynjälä
- Department of Health Sciences, Research Center for Health Promotion, University of Jyväskylä, P.O. Box 35, 40014 Jyväskylä, Finland
| | - Raili Välimaa
- Department of Health Sciences, Research Center for Health Promotion, University of Jyväskylä, P.O. Box 35, 40014 Jyväskylä, Finland
| | - Jari Villberg
- Department of Health Sciences, Research Center for Health Promotion, University of Jyväskylä, P.O. Box 35, 40014 Jyväskylä, Finland
| | - Lasse Kannas
- Department of Health Sciences, Research Center for Health Promotion, University of Jyväskylä, P.O. Box 35, 40014 Jyväskylä, Finland
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Vuori MT, Kannas LK, Villberg J, Ojala SAK, Tynjälä JA, Välimaa RS. Is physical activity associated with low-risk health behaviours among 15-year-old adolescents in Finland? Scand J Public Health 2011; 40:61-8. [PMID: 22042742 DOI: 10.1177/1403494811423429] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS To investigate the associations between physical activity and the pattern of risk health behaviour consisting of smoking, alcohol consumption, snuff (snus), cannabis, and condom use among 15-year-old adolescents, taking their educational aspirations and family affluence into account. METHODS The data were collected in the Health Behaviour in School-aged Children (HBSC) study in Finland in 2006. Standardised questionnaires were issued at schools to a 15-year-old nationally representative sample, of which 84.5% (1710 pupils) participated. Logistic regression analysis was used to explore the associations between physical activity, pattern of risk health behaviour, family affluence, and educational aspirations. Separate models for daily moderate-to-vigorous physical activity (MVPA) and leisure-time physical activity (LTPA) were tested. Multi-level analysis was performed in order to control the nested characteristics of the data. RESULTS Boys were significantly more physically active and used alcohol, cannabis, and snuff more often than girls. Girls had used a condom in their last intercourse less often than boys. The educational aspirations for higher education had the strongest association with the low-risk health behaviour, with the odds ratios in the MVPA model 3.30 (95% CI 2.41-4.55) for the boys and 3.46 (95% CI 2.56-4.67) for the girls. In the LTPA model, the corresponding odds ratios were 3.31 (95% CI 2.40-4.56) for the boys and 3.52 (95% CI 2.60-4.56) for the girls. CONCLUSIONS Physical activity was not significantly associated with the low-risk health behaviour, whereas educational aspirations for higher education showed the strongest association. The results support the earlier studies indicating a social gradient in health-related behaviour already in adolescence.
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Affiliation(s)
- Mika T Vuori
- Promoting Health and Functional Ability, Tampere, Finland.
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Kuninkaanniemi H, Villberg J, Vanhala M, Poskiparta M. Behaviour-change interventions in primary care: influence on nutrition and on the metabolic syndrome definers. Int J Nurs Pract 2011; 17:470-7. [PMID: 21939478 DOI: 10.1111/j.1440-172x.2011.01968.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The purpose of this paper was to examine whether interventions influenced patients' (i) consumption of fish; whole grain products; fruits and vegetables; (ii) overall nutrition, that is, the three former as an index; and (iii) clinical outcomes in terms of metabolic syndrome definers. A questionnaire was delivered to adult patients entering the nine health centres on November 2006 (n = 1211). During the year the ward personnel conducted intervention on patients with unhealthy habits. The 12-month follow up was conducted by mailings. Also clinical data of pre- and post-intervention values of metabolic syndrome definers were collected. For the analyses, intervention was divided into brief (≤ 15 min, at most three visits) and extended (> 15 min, more than three visits) intervention. Logistic Regression and manova were used to measure changes in the outcomes. Nutrition-related intervention was conducted on 218 patients (brief intervention n = 179, extended intervention n = 39). In the extended intervention group it was three times more likely to have a positive change in the nutrition index than in the brief intervention group (P = 0.017, confidence interval 1.223-7.773). In conclusion, brief interventions were commonly used in the primary care. However, they were not enough to produce changes in the patients' nutrition or in the clinical outcomes.
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Affiliation(s)
- Hanna Kuninkaanniemi
- Research Centre for Health Promotion, Faculty of Sport and Health Sciences, Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
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Gobina I, Välimaa R, Tynjälä J, Villberg J, Villerusa A, Iannotti RJ, Godeau E, Gabhainn SN, Andersen A, Holstein BE. The medicine use and corresponding subjective health complaints among adolescents, a cross-national survey. Pharmacoepidemiol Drug Saf 2011; 20:424-31. [DOI: 10.1002/pds.2102] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Revised: 12/13/2010] [Accepted: 12/14/2010] [Indexed: 11/09/2022]
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Liu Y, Wang M, Tynjälä J, Lv Y, Villberg J, Zhang Z, Kannas L. Test-retest reliability of selected items of Health Behaviour in School-aged Children (HBSC) survey questionnaire in Beijing, China. BMC Med Res Methodol 2010; 10:73. [PMID: 20696078 PMCID: PMC2927607 DOI: 10.1186/1471-2288-10-73] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.6] [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: 03/26/2010] [Accepted: 08/10/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Children's health and health behaviour are essential for their development and it is important to obtain abundant and accurate information to understand young people's health and health behaviour. The Health Behaviour in School-aged Children (HBSC) study is among the first large-scale international surveys on adolescent health through self-report questionnaires. So far, more than 40 countries in Europe and North America have been involved in the HBSC study. The purpose of this study is to assess the test-retest reliability of selected items in the Chinese version of the HBSC survey questionnaire in a sample of adolescents in Beijing, China. METHODS A sample of 95 male and female students aged 11 or 15 years old participated in a test and retest with a three weeks interval. Student Identity numbers of respondents were utilized to permit matching of test-retest questionnaires. 23 items concerning physical activity, sedentary behaviour, sleep and substance use were evaluated by using the percentage of response shifts and the single measure Intraclass Correlation Coefficients (ICC) with 95% confidence interval (CI) for all respondents and stratified by gender and age. Items on substance use were only evaluated for school children aged 15 years old. RESULTS The percentage of no response shift between test and retest varied from 32% for the item on computer use at weekends to 92% for the three items on smoking. Of all the 23 items evaluated, 6 items (26%) showed a moderate reliability, 12 items (52%) displayed a substantial reliability and 4 items (17%) indicated almost perfect reliability. No gender and age group difference of the test-retest reliability was found except for a few items on sedentary behaviour. CONCLUSIONS The overall findings of this study suggest that most selected indicators in the HBSC survey questionnaire have satisfactory test-retest reliability for the students in Beijing. Further test-retest studies in a large and diverse sample, as well as validity studies, should be considered for the future Chinese HBSC study.
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Affiliation(s)
- Yang Liu
- Research Centre for Health Promotion, Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
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Abstract
The purpose of this article is to examine the current health promotion orientation of youth sports clubs in Finland in view of the standards created previously for the health promoting sports club (HPSC). Ninety-seven youth sports clubs participated, and 273 sports club officials and 240 coaches answered the questionnaires. To describe clubs health promotion orientations, an HPSC index was created. The HPSC index was formulated on sub-indices by factor analysis. The sub-indices were: policy, ideology, practice and environment indexes. The results indicate that youth sports clubs are fairly health promoting in general. On average, the clubs fulfilled 12 standards for HPSC out of 22. Every fourth club was categorized as higher health promoting (≥ 15 fulfilled standards), and every third as lower health promoting (<11 fulfilled standards). The variation between clubs was wide. The clubs that had been recognized as exemplary and hence certified by the Young Finland Association were more likely to recognize health promotion than non-certified clubs (OR = 2.36, p = 0.016). The sports club officials were twice as likely to evaluate their clubs as higher health promoting than the coaches (OR = 2.04, p = 0.041). Under the sub-indices, ideologies were recognized best, others less. These findings indicate that minority of the youth sports clubs have realized health promotion comprehensively as a part of their activities. There is a lot of need for development, especially in the area of health promotion policies and practices. The instruments used proved valid and reliable and can therefore be recommended for international use.
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Affiliation(s)
- Sami Kokko
- Research Center for Health Promotion, Department of Health Sciences, University of Jyväskylä FIN-40014, Jyväskylä, Finland.
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