Food and beverage selection in children's sports arenas in Norway: a cross-sectional study.

OBJECTIVE: To assess the selection of foods and beverages in children's sports arenas in Norway. DESIGN: A cross-sectional study design with a digital questionnaire was used. Descriptive statistics were used to present the results. Moreover, Pearson's χ2 tests examined the factors that could aid in distinguishing clubs with healthy or unhealthy consumables. SETTING: Children's sports clubs in Norway. PARTICIPANTS: Representatives from 301 children's sports clubs in Norway answered the questionnaire between September and November 2021. RESULTS: In total, 89·4% of the participating sports clubs (n 301) offered soda drinks with sugar. Most of the sports clubs (88 %) reported to offer batter-based cakes such as pancakes and waffles and 63·8 % offered cakes. Furthermore, 47·5% sold hot dishes with processed meat, such as hamburgers and hot dogs. More than 80% of the sports clubs offered sweets and snacks, while 44·5% did not offer fruits, vegetables and/or berries. Notably, the important factors that distinguished sports clubs with healthier food selections from those with unhealthier selections were the presence of guidelines for the food offered and purchase agreements with food suppliers. CONCLUSIONS: Educational, governmental guidelines for the promotion of healthy eating and establishing agreements with suppliers of healthier foods could help to overcome barriers to unhealthy food selection.

Facilitators and barriers to online group work in higher education within health sciences - a scoping review.

INTRODUCTION: In health education, group work is essential to prepare students for working in health care and medical teams. Following the widespread adoption of online teaching, group work increasingly takes place in online environments. Although successful group work can provide good learning outcomes, it is unclear what facilitates or hinders online group work in health science education, and to what extent this topic has been addressed. Thus, this scoping review aimed to identify the facilitators and barriers to online group work in higher health education, provide an overview of the scientific literature related to the topic, and identify knowledge gaps in the research. METHODS: This scoping review was guided by the methodological framework described by Arksey and O'Malley, and reporting is in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Review (PRISMA-ScR). Eight online databases were searched for scientific articles published between 2012 and 2022. At least two researchers independently screened records and full-text articles and charted data including article characteristics and key information related to the research question. Findings were categorized and summarized based on the Community of Inquiry Framework. RESULTS: After screening 3671 records and 466 full-text articles, 39 articles met the inclusion criteria. The review revealed smaller group size, consistency in group composition and joint responsibility to be facilitators. Challenges with group communication, scheduling synchronous meetings and technical issues were identified as barriers. Our findings supported the importance of all three elements of the Community of Inquiry Framework: social, cognitive, and teaching presence. CONCLUSION: This review provides an overview of facilitators and barriers to online group work in health science education. However, there is a need for further investigation of these factors and studies addressing this topic from the teachers' perspective.

Adolescents' experiences with the food selection at the sports arena in the area of Oslo, Norway: a focus group study.

OBJECTIVE: To investigate adolescents' experiences with the food selection at the sport arena. DESIGN: Four focus group interviews were conducted with 4-6 participants each. Interviews were recorded and transcribed verbatim. The transcripts were coded in NVivo and the analysis was guided by thematic analysis. SETTING: Adolescents from handball and football clubs in Oslo and Viken, Norway, participated in the study. PARTICIPANTS: A total of nine boys (11-14 years old) and ten girls (11-14 years old) participated in the study. RESULTS: We identified four main themes: interest for healthy food; experiences with the food selection at the sports arena; factors influencing participants' food choices at the sports arena and expectations related to a healthy food selection at the sports arena. Adolescents across the focus groups experienced the food selection at the sports arena as unhealthy. Price, marketing and availability of unhealthy food were important factors that influenced their food choices at the sports arena. The trainer appeared to motivate the participants to eat healthy. CONCLUSIONS: Participants wished for a healthier food selection at the sports arena. Cost of food emerged as a factor that influenced their food choices. Our study also indicates that marketing of unhealthy food and beverages should be restricted, to influence adolescence food choice towards healthier alternatives.

Experiences of social support by participants with morbid obesity who participate in a rehabilitation program for health-behavior change: a qualitative study.

BACKGROUND: Obesity is a global public health concern with significant implications for individuals' physical health and overall well-being. Health-behavior change programs are crucial for addressing obesity and its associated health risks. Social support plays a central role in facilitating successful outcomes in these programs, yet limited qualitative research exists on the experiences of individuals with morbid obesity participating in such interventions. Thus, this study explores how participants with morbid obesity experienced social support in a group-based rehabilitation program for health-behavior change. METHODS: Fourteen participants in a group-based rehabilitation health-behavior change program in Norway were interviewed using semi-structured interviews. Data were analyzed with thematic analysis. RESULTS: The thematic analysis revealed three primary sources of social support: support from other participants in the group, social support from family and friends, and support from the interdisciplinary team. The participants emphasized the significance of ongoing social support throughout their health-behavior change program. Participants appreciated fostering a sense of community and regular interaction with other members of the program to ensure ongoing social support. CONCLUSIONS: Participants outlined the importance of maintaining a sense of community in the group and appreciated platforms for facilitating ongoing interactions and support among group participants. Future studies should focus on long-term interventions, tailored approaches for individuals with diverse needs involving family and friends, and the impact of enhanced peer support. By understanding the role of social support in health-behavior change programs, interventions can be optimized to better support individuals with morbid obesity.

Experiences of living with binge eating disorder and facilitators of recovery processes: a qualitative study.

BACKGROUND: Binge eating disorder (BED) is the most prevalent eating disorder worldwide. BED is often associated with low quality of life and mental health problems. Given the complexity of the disorder, recovery may be challenging. Since BED was only recently specified as a diagnostic category by the World Health Organization (2021), little is known about how patients experience living with BED in everyday life. This study aimed to explore how patients experience living with BED and to investigate factors perceived as facilitating recovery. METHOD: Individual interviews were conducted with six patients in a rehabilitation programme for recovery from BED. Interviews were conducted digitally and verbally transcribed between December 2020 and January 2021. The analysis was based on Malterud's systematic text condensation. RESULTS: Being diagnosed with BED could be experienced as a relief. The participants perceived living with BED as a challenging addiction. They struggled with a low self-image and experienced a lack of understanding from others, resulting in shame. Self-compassion and social support from friends and family and through participation in a rehabilitation programme were important facilitators of recovery. CONCLUSION: Participants perceived living with BED as a challenging addiction. They struggled with low self-esteem and experienced a lack of understanding from others, resulting in shame. Being diagnosed with BED was perceived as a relief. They appreciated that issues related to mental health were addressed during rehabilitation to better understand the complexity of BED. Knowledge about BED, as well as the difficulties of living with BED among family members and friends might help patients with BED feel less ashamed of their disorder and could thus contribute to increased self-compassion.

We interviewed six patients with binge eating disorder (BED) about their experiences living with BED, which is the most prevalent eating disorder worldwide. However, difficulties diagnosing patients with BED and a lack of knowledge about BED among healthcare professionals make it challenging to provide patients with appropriate help to recover from BED. The participants in our study participated in a rehabilitation programme for BED. They experienced living with BED as a challenging addiction. Low self-image and others' lack of understanding made the individuals ashamed of their eating disorders. Self-compassion and social support through taking part in the rehabilitation programme were important facilitators of recovery. This study indicates that more knowledge about BED among family members, friends and healthcare professionals and social support are notable facilitators for recovering from BED.

A qualitative study of public health nurses' experiences detecting and preventing child maltreatment in primary care settings.

AIM: To explore how public health nurses in child and family health centres experience detecting and preventing child maltreatment. DESIGN: Qualitative study. METHODS: Fourteen semi-structured individual interviews with public health nurses who worked in 11 different child and family health centres were conducted. The interviews were analysed using thematic analysis. RESULTS: Three themes were identified: (i) integrating knowledge to prevent child maltreatment as part of their everyday job, (ii) striving hard to detect child maltreatment and (iii) experiencing the assignment to be complex and demanding. CONCLUSION: Despite extensive experience, knowledge and following the guidelines, public health nurses in this study had difficulties finding children exposed to child maltreatment in child and family health centres. Public health nurses called for mutual multidisciplinary cooperation with other services and organizational facilitation, such as enough time and clear guidelines to effectively address this issue. IMPLICATIONS FOR PRACTICE: This study provides knowledge about how public health nurses work with child maltreatment at the Child and Family Health Center, which can serve as valuable foundation for further research as well for collaborating services. REPORTING METHOD: EQUATOR guidelines were followed, using the COREQ checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Development and Evaluation of a Serious Game Application to Engage University Students in Critical Thinking About Health Claims: Mixed Methods Study.

BACKGROUND: Misleading health claims are widespread in the media, and making choices based on such claims can negatively affect health. Thus, developing effective learning resources to enable people to think critically about health claims is of great value. Serious games can become an effective learning resource in this respect, as they can affect motivation and learning. OBJECTIVE: This study aims to document how user insights and input can inform the concept and development of a serious game application in critical thinking about health claims in addition to gathering user experiences with the game application. METHODS: This was a mixed methods study in 4 successive phases with both qualitative and quantitative data collected in the period from 2020-2022. Qualitative data on design and development were obtained from 4 unrecorded discussions, and qualitative evaluation data were obtained from 1 recorded focus group interview and 3 open-ended questions in the game application. The quantitative data originate from user statistics. The qualitative data were analyzed thematically, and user data were analyzed using nonparametric tests. RESULTS: The first unrecorded discussion revealed that the students' (3 participants') assessment of whether a claim was reliable or not was limited to performing Google searches when faced with an ad for a health intervention. On the basis of the acquired knowledge of the target group, the game's prerequisites, and the technical possibilities, a pilot of the game was created and reviewed question by question in 3 unrecorded discussions (6 participants). After adjustments, the game was advertised at the Oslo Metropolitan University, and 193 students tested the game. A correlation (r=0.77; P<.001) was found between the number of replays and total points achieved in the game. There was no demonstrable difference (P=.07) between the total scores of students from different faculties. Overall, 36.3% (70/193) of the students answered the evaluation questions in the game. They used words such as "fun" and "educational" about the experiences with the game, and words such as "motivating" and "engaging" related to the learning experience. The design was described as "varied" and "user-friendly." Suggested improvements include adding references, more games and modules, more difficult questions, and an introductory text explaining the game. The results from the focus group interview (4 participants) corresponded to a large extent with the results of the open-ended questions in the game. CONCLUSIONS: We found that user insights and inputs can be successfully used in the concept and development of a serious game that aims to engage students to think critically about health claims. The mixed methods evaluation revealed that the users experienced the game as educational and fun. Future research may focus on assessing the effect of the serious game on learning outcomes and health choices in randomized trials.

Cultural Sensitivity in Interventions Aiming to Reduce or Prevent Intimate Partner Violence During Pregnancy: A Scoping Review.

Intimate partner violence (IPV) around the time of pregnancy is a recognized global health problem. Ethnic minorities and immigrant pregnant women experiencing IPV require culturally responsive health services. The aim of this scoping review was to identify aspects of cultural sensitivity in interventions to prevent or reduce IPV among ethnic minorities and immigrant pregnant women in high-income countries. Eight databases were searched in November 2019. Any type of scientific research, quantitative, qualitative, or mixed methods studies regarding interventions against IPV among pregnant women were considered for inclusion. Resnicow et al.'s definition of cultural sensitivity was used to identify aspects of cultural sensitivity. Ten papers relating to nine interventions/studies met our inclusion criteria. These studies, which included randomized controlled trials, a mixed methods study, a program evaluation, and a longitudinal study, were conducted in Australia, Belgium, Norway, and the United States. Aspects of surface cultural sensitivity, including the translation of intervention content into the language of the target group(s) and the involvement of bilingual staff to recruit participants, were identified in eight studies. Deep structure aspects of cultural sensitivity were identified in one study, where the intervention content was pretested among the target group(s). Results that could be related to the culture-sensitive adaptions included successful recruitment of the target population. Three studies were planning to investigate women's experiences of interventions, but no publications were yet available. This scoping review provides evidence that culturally sensitive interventions to reduce or prevent IPV among immigrant pregnant women are limited in number and detail.

Experiences with Gluten-Free Bread: A Qualitative Study Amongst People with Coeliac Disease Participating in a Randomised Controlled Trial.

BACKGROUND: Whole-grain bread can be an important source of fibre for people with coeliac disease (CeD) who must adhere to a gluten-free diet and avoid consuming wheat, rye and barley. Gluten-free bread frequently has a lower nutritional quality and different texture relative to gluten-containing counterparts. OBJECTIVE: The aim was to investigate experiences with gluten-free bread amongst people with CeD prior to and during a randomised controlled trial (RCT). DESIGN: We conducted individual interviews with 10 people with CeD participating in a RCT that aimed to investigate the effects of fibre-rich gluten-free products on metabolic regulation in people with CeD compared with benchmark gluten-free products. Five participants were in the control group (benchmark gluten-free bread) and five participants in the intervention group (fibre-rich gluten-free bread). The fibre-rich gluten free bread was formulated and prepared by the project group. The benchmark gluten-free bread was commercially available. The RCT lasted for four weeks. Interviews were conducted digitally between October 2021 and January 2022 and were thematically analysed. RESULTS: Participants in both groups appeared to avoid bread prior to the study, primarily due to the poor taste and chewy consistency of the available bread in food stores and bakeries. Participants preferred the fibre-rich intervention bread as opposed to the available bread in the food market. However, participants had to become accustomed to eating the fibre-rich whole-grain bread during the study, since they avoided eating store-bought bread that they experienced chewy and not filling. CONCLUSIONS: Participants asked for fibre-rich gluten-free bread products that are satiating and have a good texture. Palatable gluten-free bread products might be an important source of fibre for people with CeD.

Attitudes towards and experiences with sourdough and baker's yeast bread amongst participants in a randomised controlled trial: a qualitative study.

Background: Bread is an important source of dietary fibre. However, an increasing number of individuals exclude bread from their habitual diet for various reasons. In recent years, sourdough bread has increased in popularity, and clinical studies have indicated that sourdough bread may decrease gastrointestinal symptoms. Objective: To investigate attitudes towards and experiences with sourdough and baker's yeast bread amongst participants in a randomised controlled trial (RCT), the health effects and consumer aspects of bread (HELFAB) study. Design: We conducted individual interviews with 10 participants who stated to be sceptical about bread and who participated in an RCT to investigate the health effects of sourdough bread versus baker's yeast bread. The participants were interviewed on two occasions (before and after the RCT). Interviews were conducted digitally between September and December 2020 and were thematically analysed. Results: Half of the interviewed participants experienced gastrointestinal symptoms, such as pain in the stomach, when they consumed bread prior to the RCT. They often preferred sourdough bread to baker's yeast bread both before and after the study, since they found that sourdough bread was easier to digest. Participants who were sceptical about bread prior to the study became more positive about bread because of their experiences with the intervention breads. This finding was mainly related to the taste and consistency of sourdough bread. The participants often associated bread with healthiness, mainly due to the dietary fibre content in bread. Conclusions: Sourdough bread with increased dietary fibre may be an important source of dietary fibre for those who perceive gastrointestinal problems from baker's yeast bread. Participants in this qualitative study stated to change their attitudes towards bread, mainly due to perceived healthiness of the intervention bread.

Is Interprofessional Learning Only Meant for Professions Within Healthcare? - A Qualitative Analysis of Associations with the Term Interprofessional Collaborative Learning Among Professional Students.

Purpose: The main goal of interprofessional learning (IPL) is to help students from different professions develop a common understanding of how to work together in future interprofessional collaboration (IPC). When IPL courses are extended beyond healthcare study programmes to include students from education and social care study programmes, the complexity increases. Since lack of communication and collaboration among professionals is a major challenge in welfare services, there is a need to explore professional students' associations with IPL. Thus, this study aims to explore what students in healthcare, teaching education and social care study programmes associate with the term "interprofessional collaborative learning". Participants and Methods: The study used student data from an ongoing IPL study at one of the largest state universities in Norway. Students from healthcare, social care and educational teaching bachelor programmes answered the following open-ended question in an online cross-sectional evaluation survey: "What do you associate with the term interprofessional collaborative learning?" We analysed data qualitatively from first- (n = 261) and second-year students (n = 97) collected during December 2019 and 2020. Most second-year students took an IPL course during their first year of study. Results: Overall, the students across all professions expressed positive associations with IPL. The most eminent category was that students associated IPL with collaboration, followed by learning and learning how to collaborate. First-year students were also associated with gaining and sharing knowledge and competencies with IPL. Understanding roles was eminent among second-year students in teaching education. Conclusion: This study supports the importance of IPL across different educational backgrounds since students seemed to have positive associations with the term and a common understanding that IPL involves several professions. The finding that teacher students highlighted the understanding of roles when working with children, young adults and their families, further supports expanding IPL beyond specialised professions within healthcare.

Safe Pregnancy intervention for intimate partner violence: a randomised controlled trial in Norway among culturally diverse pregnant women.

BACKGROUND: Intimate partner violence (IPV) during pregnancy is a global health problem with adverse consequences for mothers, infants and families. We hypothesise that information about IPV and safety behaviours during pregnancy has the potential to increase quality of life and the use of safety behaviours and prevent IPV. METHODS: A multicentre randomised controlled trial among culturally diverse pregnant women in Norway, to test the effect of a tablet-based video intervention about IPV and safety behaviours. Women attending routine antenatal check-ups alone (baseline) were screened for violence (Abuse Assessment Screen) by responding to questions on a tablet, and randomised (1:1) by computer to receive an intervention or a control video. The intervention video presented information about IPV and safety behaviours. The controls viewed a video promoting healthy pregnancy in general. Outcome measures were assessed three months post-partum: The World Health Organization Quality of Life-BREF, the Composite Abuse Scale on violence during the last 12 months and use of safety behaviours based on a 15-item checklist. A general linear model for repeated measures was used to examine the intervention's effect. The analyses were conducted by intention to treat. RESULTS: Among 1818 eligible women, 317 reported IPV and were randomised to an intervention (157) or a control group (160). A total of 251 (79.2%) women completed the follow-up questionnaire: 120 (76.4%) in the intervention group and 131 (81.9%) in the control group. At follow-up, 115 (45.8%) women reported a history of IPV. Few women (n = 39) reported IPV during the last 12 months. No differences in quality-of-life domains and overall quality of life and health were found between the intervention and the control groups. We detected no differences between the use of safety behaviours or IPV frequency and severity during the last 12 months. CONCLUSION: Our intervention did not improve women's quality of life, use of safety behaviours or exposure to violence. Nevertheless, a tablet-based tool may motivate women experiencing IPV to seek help and support. More research is needed regarding tablet-based interventions for women experiencing IPV, particularly culturally sensitive interventions. TRIAL REGISTRATION: NCT03397277 registered in clinicaltrials.gov on 11/01/2018.

Knowledge of gestational diabetes mellitus at first consultation in a multi-ethnic pregnant population in the Oslo region, Norway - a cross-sectional study.

Objectives: Gestational diabetes mellitus (GDM) is an increasing problem among pregnant women globally and is associated with short- and long-term consequences for both mother and newborn. The aim of this study was to investigate knowledge of GDM among a multi-ethnic pregnant population at first consultation for GDM in the Oslo region in Norway.Design: We conducted a cross-sectional study using baseline data from a randomised controlled study performed at five diabetic outpatient clinics (DOC) in the Oslo region. Pregnant women diagnosed with GDM following an Oral Glucose Tolerance test (OGTT) with a 2-hours blood glucose level of ≥ 9 mmol/l were included. Women filled out a questionnaire on an electronic tablet at the study entry, and additional data were collected through a recruiting form. Descriptive statistics were performed and associations were investigated using Chi-square test and multiple logistic regression analysis.Results: Of 238 women included in the study, 108 (45.4%) were native Norwegian speakers and 130 (54.6%) were non-native Norwegian speakers. 39.5% of the non-native Norwegian speakers were Asian, 22.5% were African, and 15.5% were from Eastern European Countries. Non-native Norwegian speakers were significantly more likely to have poor knowledge of GDM compared to native Norwegian speakers, adjusted OR = 4.5, 95% CI 1.61-12.5. Sensitivity analyses showed this was not due to poor language skills.Conclusions: Ethnic background was associated with the level of knowledge of GDM. Health professionals should be aware of the various knowledge levels concerning GDM and tailor their information towards women's knowledge. Linguistically- and culturally adapted information regarding GDM may improve knowledge gaps among women with immigrant backgrounds.

Facilitators of and barriers to collaboration between universities and the food industry in nutrition research: a qualitative study.

BACKGROUND: Unhealthy food is one of the main risk factors for non-communicable diseases. Improved knowledge about healthy and sustainable food products requires nutrition research in collaboration between universities and the food industry. OBJECTIVE: To investigate the facilitators of and barriers to university-industry collaborations in nutrition research. DESIGN: Semi-structured, individual interviews with five researchers in universities and five employees in the food industry were conducted in the Oslo region, Norway. Interviews were thematically analysed and guided by Braun and Clark. RESULTS: This study showed positive experiences and attitudes towards a university-industry collaboration within nutrition research aiming for healthier food products. The main facilitators of good collaboration were common goals, the exchange of knowledge and the opportunity for research funding. Barriers to good collaboration were prejudices related to the food industry's goals and previous experiences of time-consuming projects. Interestingly, collaboration agreements were identified as both facilitators of and barriers to good collaboration. CONCLUSION: Stimulating university-food industry collaboration requires increased juridical assistance, provided that the lawyers involved understand the parties' interests and the need to balance those interests and safeguard mutual trust. In addition, the food industry must take a clearer role in their engagement in public health to improve their trustworthiness in relation to research results.

Development of and Experiences With an Informational Website on Early Labor: Qualitative User Involvement Study.

BACKGROUND: The period of regular contractions before 4 cm of cervical dilatation is often referred to as the latent phase or early labor. Women find it challenging to prepare for and cope with this phase of labor, and easily accessed web-based information from reliable sources may be useful in this preparation. OBJECTIVE: The aim of this study is to describe the development of a Norwegian website, Latens.no, for people seeking information on early labor and to explore users' experiences with the website to increase its user-friendliness. METHODS: We developed a website using an iterative process involving a multidisciplinary research team, health personnel, users, a graphic designer, and an expert in software development. We explored the website's user-friendliness using semistructured individual interviews and the think-aloud method. All interviews were audio recorded and transcribed. We then analyzed the participants' feedback on the website. RESULTS: Participants included women who had recently given birth to their first baby (n=2), women who were pregnant with their first baby (n=4), and their partners (n=2). Results from participants' experiences completing tasks included positive feedback related to the content of Latens.no, positive feedback related to the website's design, and suggestions for improvement. Participants wanted to find information on early labor on the internet. Moreover, they found the information on the website relevant, trustworthy, and easy to read, and the design was attractive and easy to use. Overall, the participants performed the tasks easily, with few clicks and minimal effort. CONCLUSIONS: The think-aloud method, while performing tasks, allowed for detailed feedback. The participants confirmed the user-friendliness of the website but at the same time provided information enabling improvement. We expect that changes made based on this user-centered design study will further increase the usability and acceptability of Latens.no.

Intimate partner violence and the association of pregnancy intendedness - A cross-sectional study in southeastern Norway.

OBJECTIVES: Unintended pregnancy in the context of intimate partner violence (IPV) is a public health issue. It is associated with increased health risks for women and their children. Our objective was to investigate the association between unintended pregnancy and emotional, physical and sexual IPV in a multi-cultural population attending routine antenatal care. STUDY DESIGN: A prospective cross-sectional study of 1788 pregnant women who filled out a questionnaire during pregnancy as part of a randomized controlled trial conducted in southeastern Norway. MAIN OUTCOME MEASURES: Pregnancy intendedness was measured by asking women if their pregnancy was planned or not. The Abuse Assessment Screen and the Composite Abuse Scale R-SF, consisting of descriptive questions, were used to measure IPV. Chi-square tests, a Mann-Whitney U test, and binary logistic regression analysis were used. RESULTS: Almost one in five women (17.4%) reported that their current pregnancy was unintended. Women with unintended pregnancy were significantly younger, had lower educational backgrounds, more limited economic resources and were more likely to be non-native Norwegian speakers. A total of 15.3% of the women reported some experience of IPV in their lifetime. These women were significantly more likely to experience an unintended pregnancy than women who had not experienced IPV, after adjusting for confounding factors: AOR = 1.74 (95% CI [1.23-2.47]). CONCLUSIONS: Women who had experienced IPV were significantly more likely to have an unintended pregnancy than women who had not experienced IPV. It is of major importance to identify those women and offer appropriate services during pregnancy.

Pregnant Women's Attitudes Toward and Experiences With a Tablet Intervention to Promote Safety Behaviors in a Randomized Controlled Trial: Qualitative Study.

BACKGROUND: Intimate partner violence (IPV) is recognized as a global health problem. Women with low education and limited resources are more vulnerable, as are immigrant women. There is a lack of evidence on how health care professionals should communicate about and intervene against IPV during pregnancy. Earlier research has shown that when women manage digital questionnaires, they are more likely to disclose IPV. However, little is known about how women experience eHealth interventions with safety behaviors to prevent IPV. OBJECTIVE: The aim of this study was to explore pregnant women's attitudes toward and experiences with a tablet intervention to promote safety behaviors in a randomized controlled trial (RCT) in antenatal care. METHODS: Individual semistructured interviews were conducted with 10 women who participated in the Safe Pregnancy Study. The Safe Pregnancy Study was a randomized controlled trial (RCT) using a tablet intervention containing IPV questions and a film to promote safety behaviors. Six women from the intervention group and four women from the control group were recruited. The content was available in Norwegian, Somali, and Urdu. Five of the women participating in the interviews spoke Norwegian at home and five spoke another language. The majority of the women who did not speak Norwegian at home perceived themselves as relatively well integrated. The interviews were conducted at different maternal and child health centers (MCHCs) in Norway between March 2020 and June 2020. The analysis was guided by thematic analysis. RESULTS: Women who participated in the tablet intervention appreciated being asked questions about IPV on a tablet. However, it was important to supplement the tablet intervention with face-to-face communication with a midwife. The MCHC was regarded as a suitable place to answer questions and watch a film about safety behaviors. Women suggested making the tablet intervention available in other settings where women meet health care professionals. Some women expressed uncertainty about their anonymity regarding their answers in the questionnaire. We found no real differences between ethnic Norwegian and immigrant women's attitudes toward and experiences with the tablet intervention. CONCLUSIONS: Questions about IPV and a film about safety behaviors on a tablet, as a supplement to face-to-face communication, might initiate and facilitate communication about IPV in antenatal care. Uncertainty regarding anonymity has to be addressed when questions about IPV are being asked on a tablet. TRIAL REGISTRATION: ClinicalTrials.gov NCT03397277; https://clinicaltrials.gov/ct2/show/NCT03397277.

Nutritional quality and costs of gluten-free products: a case-control study of food products on the Norwegian marked.

BACKGROUND: Celiac disease is a chronic autoimmune disease triggered by gluten exposure in genetically predisposed individuals. A life-long intake of a gluten-free (GF) diet is required for its management. Wheat, rye and barley are eliminated in a GF diet and the nutritional adequacy of the diet has been questioned. In Norway, cereals and bread constitute a key role of the diet and are the main source of fiber intake. Gluten restrictions may therefore offer important implications for nutrient adequacy especially linked to fiber intake in people with celiac disease. OBJECTIVE: The aim of the study was to investigate the nutritional quality and price of GF products and compare with gluten-containing counterparts available at instead of in the Norwegian market. DESIGN: The macronutrient content of 423 unique GF products were compared with 337 equivalents with gluten. All products were selected from grocery stores and web-based shops, with the aim of including as many GF products as possible. Listed macronutrients content and price in 11 different food categories were compared to gluten-containing counterparts with Wilcoxon signed rank test. RESULTS: The GF products contained less protein and fiber, and higher content of saturated fat, carbohydrate and salt compared to the gluten-containing products. The total amount of fat was not different between the groups. A similar pattern was found within several of the food categories. More gluten-containing products met the nutrition claim "high in fiber" (fiber > 6 g/100 g) compared to the GF products. The price of the GF products was higher; ranging from 46%-443% more expensive than the gluten-containing products. CONCLUSION: GF products are less nutritious and have a higher price compared to equivalent gluten-containing products. Knowing that an unhealthy diet is the most important risk factor for developing non-communicable diseases, the nutritional quality of a GF diet needs to be addressed and should be improved.

Women's experience with receiving advice on diet and Self-Monitoring of blood glucose for gestational diabetes mellitus: a qualitative study.

OBJECTIVE: We aimed to explore how women with gestational diabetes mellitus (GDM) experience advice about diet and self-monitoring of blood glucose received in primary health care (PHC) and secondary health care (SHC) with a focus on how women perceived the care coordination and collaboration between healthcare professionals. DESIGN, SETTING AND SUBJECTS: Individual interviews were conducted with 12 pregnant women diagnosed with GDM. Six women had immigrant backgrounds, and six were ethnic Norwegian. Women received GDM care in the area of Oslo, Norway. Interviews were analysed using thematic analysis. RESULTS: Women described feeling shocked when they were diagnosed with GDM and feeling an immediate need for information about the consequences and management of GDM. Most of the women felt that their general practitioner (GP) had too little knowledge about GDM. Women with an immigrant background felt that the PHC midwives provided them with sufficient dietary advice related to GDM. Ethnic Norwegian women appreciated receiving more individually tailored dietary advice in SHC. Self-monitoring of blood glucose influenced women's daily lives; however, they perceived the training in PHC and SHC as adequate. The women experienced poor collaboration between healthcare professionals in PHC and SHC, which implied that they sometimes had to initiate follow-up steps in their GDM care by themselves. CONCLUSIONS: Ideally, women diagnosed with GDM should meet healthcare professionals with sufficient knowledge about GDM as soon as possible after being diagnosed. The collaboration between healthcare professionals involved in the care of women with GDM should be improved to avoid having women feel that they need to coordinate their own care.KEY POINTSCurrent awareness•The management of gestational diabetes mellitus requires appropriate follow-up by healthcare professionalsMain statements•Pregnant women's need for information about the consequences and management of gestational diabetes mellitus was highest immediately after diagnosis•Women perceived that they received more individually tailored information about diet and self-monitoring of blood glucose in secondary health care compared to primary health care•Women felt that general practitioners had insufficient knowledge about gestational diabetes mellitus•Based on our results, care coordination and collaboration between healthcare professionals involved in the care of women with gestational diabetes mellitus should be improved.

User-Involvement in the Development of a Culturally Sensitive Intervention in the Safe Pregnancy Study to Prevent Intimate Partner Violence.

Intimate partner violence (IPV) during pregnancy has negative health impacts on the woman and the fetus. There is a lack of evidence supporting effective interventions to prevent IPV during pregnancy. This user-involvement study was conducted to get feedback on a culturally sensitive, tablet intervention containing questions about violence and safety-behaviors and a video promoting safety behaviors. This resulted in important feedback on the intervention content. Our findings show that women are in favor of disclosing IPV via a tablet. They suggested ways to address barriers for disclosure, such as safeguarding anonymity and creating a trustful relationship with the midwife.