Effects of an Empowerment-Based Health-Promotion School Intervention on Physical Activity and Sedentary Time among Adolescents in a Multicultural Area.

Physical activity (PA) decreases with age, and interventions are needed to promote PA during adolescence, especially, among those in low-socioeconomic status (SES) areas. The aim of this study was to investigate whether a two-year, empowerment-based health-promotion school intervention had any effects on changes in (a) moderate-to-vigorous PA (MVPA), (b) sedentary time (SED), (c) exercise training (ET) frequency, and (d) ET duration, among adolescents. Participants (aged 12⁻13 years at baseline) from one intervention school and two control schools, were recruited from a multicultural area of Sweden, characterized by low-SES. During the course of the two-year intervention, a total of 135 participants (43% boys) were included in the study. The intervention was developed and implemented as a result of cooperation and shared decision-making among the researchers and the participants. MVPA and SED were measured with accelerometers, and ET frequency and duration was self-reported at the beginning of the seventh, eighth, and ninth grade, respectively. There were no significant effects of the two-year, empowerment-based health-promotion school intervention on changes in the accelerometer-measured MVPA and SED, or the self-reported ET frequency and duration, among the adolescents. Overall, the intervention was unsuccessful at promoting PA and reducing SED. Several possible explanations for the intervention's lack of effects are discussed.

Empowering aspects for healthy food and physical activity habits: adolescents' experiences of a school-based intervention in a disadvantaged urban community.

PURPOSE: This study aimed to describe adolescents' experiences of participating in a health-promoting school-based intervention regarding food and physical activity, with a focus on empowering aspects. Method: The school was located in a urban disadvantaged community in Sweden, characterized by poorer self-reported health and lower life expectancy than the municipality average. Focus group interviews with adolescents (29 girls, 20 boys, 14-15 years) and their teachers (n = 4) were conducted two years after intervention. Data were categorized using qualitative content analysis. RESULTS: A theme was generated, intersecting with all the categories: Gaining control over one's health: deciding, trying, and practicing together, in new ways, using reflective tools. The adolescents appreciated influencing the components of the intervention and collaborating with peers in active learning activities such as practicing sports and preparing meals. They also reported acquiring new health information, that trying new activities was inspiring, and the use of pedometers and photo-food diaries helped them reflect on their health behaviours. The adolescents' experiences were also echoed by their teachers. Conclusions: To facilitate empowerment and stimulate learning, health-promotion interventions targeting adolescents could enable active learning activities in groups, by using visualizing tools to facilitate self-reflection, and allowing adolescents to influence intervention activities.

Facilitators of Physical Activity: Voices of Adolescents in a Disadvantaged Community.

Despite increasing socioeconomic inequalities in the health and well-being of adolescents, the voices of adolescents in disadvantaged communities regarding facilitators of physical activity (PA) have received relatively little attention. In response, the purpose of this study was to illuminate what adolescents in a multicultural community of low socioeconomic status (SES) in Sweden convey concerning facilitators of PA. Adolescents (n = 53, aged 12-13 years) were recruited from a school in a multicultural community of low SES in Sweden. Following an interpretive approach, 10 focus group interviews were conducted to produce data for a qualitative content analysis. When the adolescents mentioned PA, they mostly referred to spontaneous PA rather than organized PA, and expressed that they enjoyed their PA engagement, which they stated was promoted by the variation of PA, available options for PA, their physical skills, and the presence of peers. They reported that social support from family and friends facilitated their PA, and they offered several suggestions regarding how the school environment could better support their PA. From the perspective of self-determination theory (SDT), the results stress the importance of facilitating intrinsic motivation with a supportive PA environment in which adolescents can satisfy their needs for autonomy, competence, and relatedness.

What undermines healthy habits with regard to physical activity and food? Voices of adolescents in a disadvantaged community.

This study aimed to illuminate factors that undermine the healthy habits of adolescents from a multicultural community with low socioeconomic status (S.E.S.) in Sweden with regard to physical activity (P.A.) and food, as stated in their own voices. Adolescents (n = 53, 12-13 y/o) were recruited from one school situated in a multicultural community characterized by low S.E.S. Embracing an interpretive approach, 10 focus-group interviews were conducted to produce data for the study. The focus-group interviews were audio recorded, transcribed verbatim, and analysed using qualitative content analysis. The analysis resulted in two major themes: (1) the availability of temptations is large, and support from the surroundings is limited; and (2) norms and demands set the agenda. The adolescents' voices illuminate a profound awareness and the magnitude of tempting screen-based activities as undermining their P.A. and healthy food habits. Moreover, several gender boundaries were highlighted as undermining girls' P.A. and healthy food habits. The adolescents' stories illuminated that it is difficult for them, within their environment, to establish healthy habits with regard to P.A. and food. To facilitate the adolescents' healthy habits, we suggest that support from family, friends, the school, and society at large is essential.

Health on the Internet: implications for health promotion.

The aim of this article is to discuss the implications of health on the Internet for health promotion, focusing in particular on the concept of empowerment. Empowering aspects of health on the Internet include the enabling of advanced information and knowledge retrieval, anonymity and convenience in accessing information, creation of social contacts and support independent of time and space, and challenging the expert-lay actor relationship. The disempowering aspects of health on the Internet are that it involves a shift towards the expert control and evaluation of sources of health information, that it widens the gap between 'information-rich' and 'information-poor' users, thus reproducing existing social divisions, and that the increase in medicalization and healthism results in increased anxiety and poorer health. The health promotive and empowering strategies presented in this article are directed at strengthening people's ability to evaluate different information sources in relation to their own interests and needs rather than in relation to scientific and/or professional standards.