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Giné-Garriga, M., Sandlund, M., Dall, P. M., Chastin, S. F. M., Pérez, S. & Skelton, D. A. (2019). A Novel Approach to Reduce Sedentary Behaviour in Care Home Residents: The GET READY Study Utilising Service-Learning and Co-Creation. International Journal of Environmental Research and Public Health, 16(3), Article ID 418.
Open this publication in new window or tab >>A Novel Approach to Reduce Sedentary Behaviour in Care Home Residents: The GET READY Study Utilising Service-Learning and Co-Creation
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2019 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 3, article id 418Article in journal (Refereed) Published
Abstract [en]

The GET READY study aimed to integrate service-learning methodology into University degrees by offering students individual service opportunities with residential care homes, to co-create the best suited intervention to reduce the sedentary behaviour (SB) of residents throughout the day, with researchers, end-users, care staff, family members and policymakers. Eight workshops with care home residents and four workshops with care staff, relatives and policymakers, led by undergraduate students, were audiotaped, transcribed verbatim and analysed with inductive thematic analysis to understand views and preferences for sustainable strategies to reduce SB and increase movement of residents. Perspectives about SB and movement in care homes highlighted four subthemes. Assets for decreasing SB included three subthemes, and suggestions and strategies encapsulated four subthemes. There is a need to include end-users in decision making, and involve care staff and relatives in enhancing strategies to reduce SB among residents if we want sustainable changes in behaviour. A change in the culture at a policymaker and care staff's level could provide opportunities to open care homes to the community with regular activities outside the care home premises, and offer household chores and opportunities to give residents a role in maintaining their home environment.

Place, publisher, year, edition, pages
MDPI, 2019
Keywords
Co-creation, service-learning, care home residents, sedentary behaviour, physical activity
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-157595 (URN)10.3390/ijerph16030418 (DOI)000459113600124 ()30717105 (PubMedID)
Available from: 2019-03-28 Created: 2019-03-28 Last updated: 2019-03-28Bibliographically approved
Pettersson, B., Wiklund, M., Janols, R., Lindgren, H., Lundin-Olsson, L., Skelton, D. A. & Sandlund, M. (2019). "Managing pieces of a personal puzzle': Older people's experiences of self-management falls prevention exercise guided by a digital program or a booklet. BMC Geriatrics, 19, Article ID 43.
Open this publication in new window or tab >>"Managing pieces of a personal puzzle': Older people's experiences of self-management falls prevention exercise guided by a digital program or a booklet
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2019 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 19, article id 43Article in journal (Refereed) Published
Abstract [en]

Background: Exercise is effective in order to prevent falls in community-dwelling older people. Self-management programs have the potential to increase access and reduce costs related to exercise-based fall prevention. However, information regarding older people's views of participating in such programs is needed to support implementation. The aim of this study was to explore older people's experiences of a self-management fall prevention exercise routine guided either by a digital program (web-based or mobile) or a paper booklet.

Methods: This qualitative study was part of a feasibility study exploring two completely self-managed exercise interventions in which the participants tailored their own program, guided either by a digital program or a paper booklet. Individual face-to-face semi-structured interviews were conducted with a purposeful sample of 28 participants (18 women), mean age 76yrs. Qualitative content analysis was used to analyse the data.

Results: Self-managing and self-tailoring these exercise programs was experienced as Managing pieces of a personal puzzle'. To independently being able to create a program and manage exercise was described in the categories Finding my own level' and Programming it into my life'. The participants experienced the flexibility and independence provided by completely self-managed exercise as positive and constructive although it required discipline. Furthermore, different needs and preferences when managing their exercise were described, as well as varying sources of motivation for doing the exercise, as highlighted in the category Defining my source of motivation'. The category Evolving my acquired knowledge' captures the participants' views of building their competence and strategies for maintenance of the exercise. It describes a combined process of learning the program and developing reflection, which was more clearly articulated by participants using the digital program.

Conclusions: This study provides new knowledge regarding experiences, preferences and motivations of older people to engage in home-based self-managed fall prevention exercise. They expressed both a capability and willingness to independently manage their exercise. A digital program seems to have strengthened the feeling of support while creating their own exercise program and tailoring it to their preferences and circumstances, which might therefore create better opportunities for adoption and adherence in the long term.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Accidental falls, Aged, Exercise, Qualitative research, eHealth, Digital health, Self-management, Falls prevention, Intervention, Behaviour change
National Category
Geriatrics Nursing
Identifiers
urn:nbn:se:umu:diva-157209 (URN)10.1186/s12877-019-1063-9 (DOI)000459122200003 ()30777026 (PubMedID)
Available from: 2019-03-26 Created: 2019-03-26 Last updated: 2019-03-26Bibliographically approved
Giné-Garriga, M., Sandlund, M., Dall, P. M., Chastin, S. F. M., Pérez, S. & Skelton, D. A. (2018). A co-created intervention with care home residents and university students following a service-learning methodology to reduce sedentary behaviour: The GET READY project protocol. Journal of Frailty, Sarcopenia and Falls, 3(3), 132-137
Open this publication in new window or tab >>A co-created intervention with care home residents and university students following a service-learning methodology to reduce sedentary behaviour: The GET READY project protocol
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2018 (English)In: Journal of Frailty, Sarcopenia and Falls, ISSN 2459-4148, Vol. 3, no 3, p. 132-137Article in journal (Refereed) Published
Abstract [en]

Background: There is a growing demand for long-term care settings. Care-home residents are a vulnerable group with high levels of physical dependency and cognitive impairment. Long-term care facilities need to adapt and offer more effective and sustainable interventions to address older residents’ complex physical and mental health needs. Despite the increasing emphasis on patient and public involvement, marginalised groups such as care-home residents, can be overlooked when including people in the research process. The GET READY project aims to integrate servicelearning methodology into Physical Therapy and Sport Sciences University degrees by offering students individual service opportunities with residential care homes, in order to co-create the best suited intervention with researchers, older adults of both genders (end-users) in care homes, health professionals, caregivers, relatives and policy makers. Methods: Stage 1 will integrate a service-learning methodology within a Physical Therapy module in Glasgow and Sport Sciences module in Barcelona, design two workshops for care home residents and one workshop for staff members, relatives and policy makers and conduct a co-creation procedure. Stage 2 will assess the feasibility, safety and preliminary effects of the co-created intervention in a group of 60 care home residents, within a two-armed pragmatic randomized clinical trial. ClinicalTrials.gov Identifier: NCT03505385.

Place, publisher, year, edition, pages
Hylonome Publications, 2018
Keywords
Co-creation, Care home residents, Physical activity, Sedentary behaviour, Service-learning methodology
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-158548 (URN)10.22540/JFSF-03-132 (DOI)
Available from: 2019-05-02 Created: 2019-05-02 Last updated: 2019-05-08Bibliographically approved
Guerrero, E., Nieves, J. C., Sandlund, M. & Lindgren, H. (2018). Activity qualifiers using an argument-based construction. Knowledge and Information Systems, 54(3), 633-658
Open this publication in new window or tab >>Activity qualifiers using an argument-based construction
2018 (English)In: Knowledge and Information Systems, ISSN 0219-1377, E-ISSN 0219-3116, Vol. 54, no 3, p. 633-658Article in journal (Refereed) Published
Abstract [en]

Based on an argumentation theory approach, we present a novel method for evaluating complex goal-based activities by generalizing a notion of qualifier defined in the health domain. Three instances of the general qualifier are proposed: Performance, Actuation and Capacity; the first one evaluates what a person does, the second how an individual follows an action plan, and the third one how "well" or "bad" an activity is executed. Qualifiers are intended to be used by autonomous systems for evaluating human activity. We exemplify our approach using a health domain assessment protocol. Main results of this test show a partial correlation between ambiguities assessed by experts and our argument-based approach; and a multi-dimensional perspective how an activity is executed when a combined evaluation of qualifiers is used. This last outcome was interesting for some therapists consulted. Results also show differences between values of qualifiers using different argumentation semantics; two scenarios were proposed by therapist for using different semantics: preliminary activity screening and time-span follow-up evaluation.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
Human activity, Argumentation theory, Logic programming, Performance Capacity, Activity evaluation
National Category
Computer Sciences
Research subject
Computer Science
Identifiers
urn:nbn:se:umu:diva-141040 (URN)10.1007/s10115-017-1112-7 (DOI)000425010800006 ()
Available from: 2017-10-23 Created: 2017-10-23 Last updated: 2018-06-09Bibliographically approved
Sandlund, M., Pohl, P., Ahlgren, C., Skelton, D. A., Melander-Wikman, A., Bergvall-Kareborn, B. & Lundin-Olsson, L. (2018). Gender Perspective on Older People's Exercise Preferences and Motivators in the Context of Falls Prevention: A Qualitative Study. BioMed Research International, Article ID 6865156.
Open this publication in new window or tab >>Gender Perspective on Older People's Exercise Preferences and Motivators in the Context of Falls Prevention: A Qualitative Study
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2018 (English)In: BioMed Research International, ISSN 2314-6133, E-ISSN 2314-6141, article id 6865156Article in journal (Refereed) Published
Abstract [en]

Background: Several factors have previously been identified to positively influence the uptake and adherence for fall prevention exercise programmes. There is, however, a lack of studies investigating if men and women differ in their views and preferences for fall prevention exercises.

Aim: To explore exercise preferences and motivators of older community-dwelling women and men in the context of falls prevention from a gender perspective.

Methods: Workshops including multistage focus group discussions were conducted with 18 older community-dwelling people with and without history of falls. Participants were purposively selected and divided into two groups. Each group met on six occasions over a period of five months. Participatory and Appreciative Action and Reflection methodology was used to guide the discussions. A qualitative content analysis approach was used in the analysis.

Results: Older participants had many diverse preferences and confirmed that individually tailored exercise, in terms of mode, intensity, challenge, and social context, is important. Moreover, important factors for exercise adherence and maintenance included the experience of individual confirmation; different spirit lifters to increase enjoyment; and personal tricks to maintain exercise routines. The individual differences within genders were more diverse than the differences between women and men.

Conclusion: Exercise interventions to prevent falls should be individually tailored, based on the specific needs and preferences of the older participant, and do not appear to require gender specific approaches. To increase adherence, intrinsic motivation for exercise may be encouraged by competence enhancing confirmations, energizing spirit lifters, and practical tips for exercise maintenance. The study provides an awareness about women's and men's preferences for fall prevention exercises, and this information could be used as guidance in designing inclusive exercise interventions.

Place, publisher, year, edition, pages
Hindawi Publishing Corporation, 2018
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-150400 (URN)10.1155/2018/6865156 (DOI)000439167500001 ()
Available from: 2018-08-06 Created: 2018-08-06 Last updated: 2018-08-06Bibliographically approved
Larsson, G., Julu, P. O. O., Engerström, I. W., Sandlund, M. & Lindström, B. (2018). Walking on treadmill with Rett syndrome: effects on the autonomic nervous system. Research in Developmental Disabilities, 83, 99-107
Open this publication in new window or tab >>Walking on treadmill with Rett syndrome: effects on the autonomic nervous system
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2018 (English)In: Research in Developmental Disabilities, ISSN 0891-4222, E-ISSN 1873-3379, Vol. 83, p. 99-107Article in journal (Refereed) Published
Abstract [en]

People with Rett syndrome have deficient central autonomic control, which may interfere with walking. We have limited knowledge regarding the effects of exertion during physical activity in Rett syndrome. The aim was to investigate the autonomic responses during walking on a treadmill in Rett syndrome. Twenty-six females, 12 with Rett syndrome and 14 healthy females were included. All individuals started on the treadmill by standing still, followed by walking slowly with progressive speed until reaching maximum individual speed, which they kept for 6 min. Heart rate (HR), systolic (SBP), diastolic (DBP), mean arterial blood pressures (MAP), cardiac vagal tone (CVT), cardiac sensitivity to baroreflex (CSB), transcutaneous partial pressures of oxygen (pO2), carbon dioxide (pCO2), and breathing movements were recorded simultaneously and continuously. Autonomic responses were assessed by MAP, CSB and CVT during walking at 3 and 6 min. The changes in CSB and CVT in people with Rett syndrome compared to controls indicated more arousal, but only when the treadmill was started; as they continued walking, the arousal dropped to control level. People with Rett syndrome exhibited little changes in pCO2 whereas the controls showed increased values during walking. This suggests poor aerobic respiration in people with Rett syndrome during walking. Five people with Rett syndrome had Valsalva type of breathing at rest, three of those had normal breathing while walking on the treadmill while the remaining two started but soon stopped the Valsalva breathing during the walk. Our results show that individuals with Rett syndrome can walk for up to 6 min at their own maximum sustainable speed on a treadmill. Energy production may be low during walking in Rett syndrome, which could cause early tiredness. A treadmill can be used in people with Rett syndrome, but must be introduced slowly and should be individually tailored. We propose that walking promotes regular breathing in Rett syndrome.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Autonomic nervous system, Exercise, Treadmill, Valsalva, Energy production, Stamina
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-154898 (URN)10.1016/j.ridd.2018.08.010 (DOI)000452684300011 ()30193160 (PubMedID)
Available from: 2019-01-07 Created: 2019-01-07 Last updated: 2019-01-07Bibliographically approved
Leask, C. F., Sandlund, M., Skelton, D. A. & Chastin, S. F. M. (2017). Co-creating a tailored public health intervention to reduce older adults' sedentary behaviour. Health Education Journal, 76(5), 595-608
Open this publication in new window or tab >>Co-creating a tailored public health intervention to reduce older adults' sedentary behaviour
2017 (English)In: Health Education Journal, ISSN 0017-8969, E-ISSN 1748-8176, Vol. 76, no 5, p. 595-608Article in journal (Refereed) Published
Abstract [en]

Objective: The increasing health care costs associated with an ageing population and chronic disease burden are largely attributable to modifiable lifestyle factors that are complex and vary between individuals and settings. Traditional approaches to promoting healthy lifestyles have so far had limited success. Recently, co-creating public health interventions with end-users has been advocated to provide more effective and sustainable solutions. The aim of this study was to document and evaluate the co-creation of a public health intervention to reduce sedentary behaviour in older adults.

Design: Community-dwelling older adults (N = 11, mean age = 74 years) and academic researchers attended 10 interactive co-creation workshops together.

Setting: Workshops took place on university campus and the co-creators completed fieldwork tasks outside the workshops.

Method: Workshops were informed by the Participatory and Appreciative Action and Reflection methodology. Data were collected using field notes, video recording and worksheet tasks. Analysis was conducted using a qualitative content analysis approach.

Results: The co-creators developed a tailored intervention delivered through a mode congruent with older adults’ lives. Key elements of the intervention included (1) education on sedentary behaviour, (2) resources to interrupt sedentary behaviour, (3) self-monitoring, (4) action planning and (5) evaluating the benefits of interrupting sedentary behaviour.

Conclusion: Co-creation is a feasible approach to develop public health interventions; however, it is limited by the lack of a systematic framework to guide the process. Future work should aim to develop principles and recommendations to ensure co-creation can be conducted in a more scientific and reproducible way. The effectiveness and scalability of the intervention should be assessed.

Keywords
Co-creation, intervention, older adults, physical activity, sedentary behaviour, sitting
National Category
Other Health Sciences
Identifiers
urn:nbn:se:umu:diva-140977 (URN)10.1177/0017896917707785 (DOI)000408777900007 ()
Available from: 2017-11-01 Created: 2017-11-01 Last updated: 2018-06-09Bibliographically approved
Sandlund, M., Skelton, D. A., Pohl, P., Ahlgren, C., Melander-Wikman, A. & Lundin-Olsson, L. (2017). Gender perspectives on views and preferences of older people on exercise to prevent falls: a systematic mixed studies review. BMC Geriatrics, 17, Article ID 58.
Open this publication in new window or tab >>Gender perspectives on views and preferences of older people on exercise to prevent falls: a systematic mixed studies review
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2017 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 17, article id 58Article in journal (Refereed) Published
Abstract [en]

Background: To offer fall prevention exercise programs that attract older people of both sexes there is a need to understand both women's and men's views and preferences regarding these programs. This paper aims to systematically review the literature to explore any underlying gender perspectives or gender interpretations on older people's views or preferences regarding uptake and adherence to exercise to prevent falls. Methods: A review of the literature was carried out using a convergent qualitative design based on systematic searches of seven electronic databases (PubMed, CINAHL, Amed, PsycINFO, Scopus, PEDro, and OTseeker). Two investigators identified eligible studies. Each included article was read by at least two authors independently to extract data into tables. Views and preferences reported were coded and summarized in themes of facilitators and barriers using a thematic analysis approach. Results: Nine hundred and nine unique studies were identified. Twenty five studies met the criteria for inclusion. Only five of these contained a gender analysis of men's and women's views on fall prevention exercises. The results suggests that both women and men see women as more receptive to and in more need of fall prevention messages. The synthesis from all 25 studies identified six themes illustrating facilitators and six themes describing barriers for older people either starting or adhering to fall prevention exercise. The facilitators were: support from professionals or family; social interaction; perceived benefits; a supportive exercise context; feelings of commitment; and having fun. Barriers were: practical issues; concerns about exercise; unawareness; reduced health status; lack of support; and lack of interest. Considerably more women than men were included in the studies. Conclusion: Although there is plenty of information on the facilitators and barriers to falls prevention exercise in older people, there is a distinct lack of studies investigating differences or similarities in older women's and men's views regarding fall prevention exercise. In order to ensure that fall prevention exercise is appealing to both sexes and that the inclusion of both men and women are encouraged, more research is needed to find out whether gender differences exists and whether practitioners need to offer a range of opportunities and support strategies to attract both women and men to falls prevention exercise.

Place, publisher, year, edition, pages
BioMed Central, 2017
Keywords
Accidental falls, Adherence, Aged, Exercise, Gender identity
National Category
Gender Studies Geriatrics
Identifiers
urn:nbn:se:umu:diva-139587 (URN)10.1186/s12877-017-0451-2 (DOI)000397451900001 ()28212622 (PubMedID)
Available from: 2017-09-20 Created: 2017-09-20 Last updated: 2018-06-09Bibliographically approved
Guerrero, E., Nieves, J. C., Sandlund, M. & Lindgren, H. (2016). Activity qualifiers in an argumentation framework as instruments for agents when evaluating human activity. In: Yves Demazeau, Takayuki Ito, Javier Bajo, Maria José Escalona (Ed.), Advances in Practical Applications of Scalable Multi-agent Systems. The PAAMS Collection: 14th International Conference, PAAMS 2016, Sevilla, Spain, June 1-3, 2016, Proceedings. Paper presented at 14th International Conference, PAAMS 2016, Sevilla, Spain, June 1-3, 2016 (pp. 133-144). Springer, 9662
Open this publication in new window or tab >>Activity qualifiers in an argumentation framework as instruments for agents when evaluating human activity
2016 (English)In: Advances in Practical Applications of Scalable Multi-agent Systems. The PAAMS Collection: 14th International Conference, PAAMS 2016, Sevilla, Spain, June 1-3, 2016, Proceedings / [ed] Yves Demazeau, Takayuki Ito, Javier Bajo, Maria José Escalona, Springer, 2016, Vol. 9662, p. 133-144Conference paper, Published paper (Other academic)
Abstract [en]

Theoretical frameworks have been developed for enabling software agents to evaluate simple activities such as walking and sitting. However, such frameworks typically do not include methods for how practically dealing with uncertain sensor information. We developed an argument-based method for evaluating complex goal-based activities by adapting two qualifiers: Performance and Capacity defined in the health domain. The first one evaluates what a person does, and the second one how "well" or "bad" an activity is executed. Our aim is to deal with uncertainty and inconsistent information; generate consistent hypotheses about the activity execution; and resemble an expert therapist judgment, where an initial hypothesis assessment can be retracted under new evidence. We conducted a pilot test in order to evaluate our approach using a Physiotherapy assessment test as a goal-based activity. Results show that skeptic argumentation semantics are may be useful for discriminating individuals without physical issues by considering Performance and Capacity; conversely, credulous semantics may be suitable for obtaining information in the evaluation of activity, which an intelligent agent may use for providing personalized assistance in an ambient assisted living environment.

Place, publisher, year, edition, pages
Springer, 2016
Series
Lecture Notes in Artificial Intelligence, ISSN 0302-9743 ; 9662
Keywords
Ambient assisted living, Intelligent agents, Argumentation theory, Argumentation semantics, Complex activities, Evaluation
National Category
Computer Sciences
Identifiers
urn:nbn:se:umu:diva-120277 (URN)10.1007/978-3-319-39324-7_12 (DOI)000378992400012 ()978-3-319-39323-0 (ISBN)978-3-319-39324-7 (ISBN)
Conference
14th International Conference, PAAMS 2016, Sevilla, Spain, June 1-3, 2016
Available from: 2016-05-13 Created: 2016-05-13 Last updated: 2018-06-07Bibliographically approved
Leask, C. F., Skelton, D. A., Sandlund, M. & Chastin, S. F. M. (2016). Co-Creating a Tailored Intervention to Reduce Sedentary Behaviour in Older Adults. Journal of Aging and Physical Activity, 24, 92-92
Open this publication in new window or tab >>Co-Creating a Tailored Intervention to Reduce Sedentary Behaviour in Older Adults
2016 (English)In: Journal of Aging and Physical Activity, ISSN 1063-8652, E-ISSN 1543-267X, Vol. 24, p. 92-92Article in journal, Meeting abstract (Other academic) Published
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-126349 (URN)10.1123/japa.24.s1.s89 (DOI)000381554400234 ()
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Special Issue

Available from: 2016-10-24 Created: 2016-10-03 Last updated: 2018-06-09Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0003-4781-862x

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