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  • 1. Asaba, Eric
    et al.
    Nakamura, Mio
    Asaba, Akie
    Kottorp, Anders
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Integrating Occupational Therapy Specific Assessments in Practice: Exploring Practitioner Experiences2017In: Occupational Therapy International, ISSN 0966-7903, E-ISSN 1557-0703, Vol. 2017, article id 7602805Article in journal (Refereed)
    Abstract [en]

    Background. Occupational therapists sometimes find it challenging to integrate client-centered and occupational therapy specific assessments in practice. The aim of this study was to explore the use of occupational therapy specific assessments such as the Assessment of Motor and Process Skills (AMPS) among occupational therapists in Sweden and Japan. Methods. Interviews and qualitative thematic analyses were utilized. Findings. Four themes are reported: (1) use it or lose it, (2) simply no space until after hours, (3) biggest barriers can be colleagues, and (4) being more specific: communication. Conclusion. In keeping with previous studies, occupational therapists often find it challenging to implement client-centered and occupation-based assessment tools into practice. However, more work is needed to understand how best practices can be incorporated into a changing occupational therapy daily practice.

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  • 2.
    Awad, Eman
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Biomedical Science (BMV).
    Ramji, Rathi
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Cirovic, Stefan
    Malmö University, Faculty of Health and Society (HS), Department of Biomedical Science (BMV).
    Rämgård, Margareta
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Shleev, Sergey
    Malmö University, Faculty of Health and Society (HS), Department of Biomedical Science (BMV). Malmö University.
    Developing and evaluating non-invasive healthcare technologies for a group of female participants from a socioeconomically disadvantaged area2021In: Scientific Reports, E-ISSN 2045-2322, Vol. 11, no 1, article id 23896Article in journal (Refereed)
    Abstract [en]

    When compared to the general population, socioeconomically disadvantaged communitiesfrequently experience compromised health. Monitoring the divide is challenging since standardizedbiomedical tests are linguistically and culturally inappropriate. The aim of this study was to developand test a unique mobile biomedical testbed based on non-invasive analysis, as well as to explorethe relationships between the objective health measures and subjective health outcomes, asevaluated with the World Health Organization Quality of Life survey. The testbed was evaluated in asocioeconomically disadvantaged neighborhood in Malmö, which has been listed as one of the twelvemost vulnerable districts in Sweden. The study revealed that compared to conventional protocolsthe less intrusive biomedical approach was highly appreciated by the participants. Surprisingly, thecollected biomedical data illustrated that the apparent health of the participants from the ethnicallydiverse low-income neighborhood was comparable to the general Swedish population. Statisticallysignificant correlations between perceived health and biomedical data were disclosed, even thoughthe dependences found were complex, and recognition of the manifest complexity needs to beincluded in further research. Our results validate the potential of non-invasive technologies incombination with advanced statistical analysis, especially when combined with linguistically andculturally appropriate healthcare methodologies, allowing participants to appreciate the significanceof the different parameters to evaluate and monitor aspects of health.

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  • 3.
    Axelsson, Malin
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Carlson, Elisabeth
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Gudmundsson, Petri
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kumlien, Christine
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Skane Univ Hosp, Vasc Ctr, Dept Cardiothorac & Vasc Surg, Malmo, Sweden..
    Jakobsson, Jenny
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Translation and validation of the Swedish version of the IPECC-SET 9 item version2022In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 36, no 6, p. 900-907Article in journal (Refereed)
    Abstract [en]

    Interprofessional Education (IPE) is essential to prepare future health-care professionals for collaborative practice, but IPE requires evaluation. One psychometrically sound instrument is the Interprofessional Education Collaborative Competence Self-Efficacy Tool consisting of nine items (IPECC-SET 9). This tool does not, to date, exist in a Swedish version. Therefore, the aim of this study was to translate and validate the Swedish version of the IPECC-SET 9. The English version was translated into Swedish and tested among 159 students in the 3-year Bachelor Programs in Nursing and in Biomedical Laboratory Science. The psychometric analysis was guided by a Rasch model, which showed that the items functioned well together, confirming unidimensionality, and that the person misfit was also lower than the set criterion. The separation index was 2.98, and the Rasch-equivalent Cronbach-alpha measure was estimated to .92, supporting internal consistency. No systematic differences on item level in IPECC-SET 9 further supported fairness in testing. The Swedish IPECC-SET 9 demonstrates sound psychometric properties and has the potential to be used as a measure of self-efficacy for competence in interprofessional collaborative practice among health profession students. However, the IPECC-SET 9 is recommended to be further tested in larger samples representing the entirety of health-care teams.

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  • 4.
    Backström, Martin Karaba
    et al.
    Lund Univ, Fac Med, Lund, Sweden..
    de Castro, Andre Luiz Moura
    Lund Univ, Fac Med, Lund, Sweden..
    Eakman, Aaron M.
    Colorado State Univ, Dept Occupat Therapy, Ft Collins, CO USA..
    Ikiugu, Moses N.
    Univ South Dakota, Sch Hlth Sci, Occupat Therapy Dept, Vermillion, SD USA..
    Gribble, Nigel
    Curtin Univ, Sch Allied Hlth, Bentley, Australia..
    Asaba, Eric
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.;Stockholms Sjukhem, Unit Res Educ Dev & Innovat, Stockholm, Sweden..
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Falkmer, Olov
    Humdrum, Perth, Australia..
    Eklund, Mona
    Lund Univ, Fac Med, Lund, Sweden..
    Ness, Nils Erik
    Norwegian Univ Sci & Technol, Occupat Therapy Programme, Trondheim, Norway..
    Balogh, Stefan
    Bosse Rad, Stod & Kunskapsctr, Stockholm, Sweden..
    Hynes, Patrick
    St Gabriels Fdn, Limerick, Ireland.;Univ Limerick, Sch Allied Hlth, Limerick, Ireland..
    Falkmer, Torbjörn
    Lund Univ, Fac Med, Lund, Sweden..
    Occupational therapy gender imbalance; revisiting a lingering issue2023In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 30, no 7, p. 1113-1121Article in journal (Refereed)
    Abstract [en]

    Background: Recently, it has been suggested that gender disparity in Occupational Therapy has to do with segregated gendered job norms that position female dominated professions as a 'step down' for many males. Interestingly, this suggestion was not underpinned by experiences of males in the profession.

    Aims and methods: Thirteen male Occupational Therapists with a variety of backgrounds were invited to this Round Table research, focussing on the broader issue of the existing gender imbalance in Occupational Therapy.

    Results: Two themes emerged: 'The core values of the profession', and 'Broadening the scope of the profession'; none of them suggesting that male/female imbalance was necessarily the most pressing issue.

    Conclusions: A gender-unrelated approach to everyday problem-solving was put forward to achieve increased diversity in Occupational Therapists' backgrounds, better reflecting the people they serve. By broadening the scope and the way the profession is presented, and encouraging innovative and more entrepreneurially driven approaches, diversity in the workforce could be further facilitated. These findings are discussed within the context of 'The mutual constitution of cultures and selves' model.

    Significance: Diversity in the Occupational therapy workforce could be further facilitated with a shift in focus away from the male/female perspective to an intersectional approach.

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  • 5. Ballmer, Thomas
    et al.
    Helle, Tina
    Kaptain, Rina Juel
    Malinowsky, Camilla
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Test-retest and inter-rater reliability of the Danish version of the management of everday technology assessment for use with older adults with and without COPD2019In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 26, no 6, p. 463-474Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The trend towards telemedicine increasingly requires clients to manage everyday technology (ET) to access and use health services. The Management of Everday Technology Assessment (META) is an observation-based instrument developed to evaluate the ability to manage ET. AIM: To examine test-retest (TRR) and inter-rater reliability (IRR) of the Danish translation of the META for older adults with and without COPD. METHOD AND MATERIALS: 47 older adults with COPD (n = 23) and without (n = 24) were recruited. IRR was examined by four raters paired across 30 participants. TRR was examined for 21 participants by the same rater administering the META twice within four weeks. A rank-based method for paired ordinal data was used to calculate percentage agreement (PA) and measures of systematic disagreement and individual variability. Mann Whitney U tests were used to compare PA to health status (presence/absence of COPD). RESULTS: Inter-rater PA was acceptable across 10 of 11 items and test-retest PA across 8 of 11 items. Systematic disagreement was present for one item in TRR. No significant differences in PA were found regarding health status. CONCLUSION: The Danish META generates reliable scores for this sample. However, conclusive statements cannot be made for all items.

  • 6.
    Bergvad, I. Buset
    et al.
    Lovisenberg Diaconal Hosp, Oslo, Norway.;Univ Oslo, Oslo, Norway..
    Lindberg, M. Falch
    Lovisenberg Diaconal Hosp, Oslo, Norway.;Univ Oslo, Oslo, Norway..
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Skou, S. Thorgaard
    Univ Southern Denmark, Odense, Denmark.;Naestved Slagelse Ringsted Hosp, Slagelse, Denmark..
    Lerdal, A.
    Lovisenberg Diaconal Hosp, Oslo, Norway.;Univ Oslo, Oslo, Norway..
    Translation and validation of a norwegian version of the satisfaction measure for use in patient undergoing total joint arthroplasty2023In: Osteoarthritis and Cartilage, ISSN 1063-4584, E-ISSN 1522-9653, Vol. 31, no S1, p. S186-S186Article in journal (Other academic)
    Abstract [en]

    Purpose: Patient satisfaction is one of the key outcomes that should be included in research after join arthroplasty, as recommended by OMERACT (Outcomes Measurement in Rheumatology)This study aims to translate and evaluate measurement properties of the Satisfaction Measure for use in patients undergoing total knee arthroplasty (TKA) and total hip arthroplasty (THA).

  • 7. Bragstad, Line Kildal
    et al.
    Lerdal, Anners
    Gay, Caryl L
    Kirkevold, Marit
    Lee, Kathryn A
    Lindberg, Maren Falch
    Skogestad, Ingrid Johansen
    Hjelle, Ellen Gabrielsen
    Sveen, Unni
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Psychometric properties of a short version of Lee Fatigue Scale used as a generic PROM in persons with stroke or osteoarthritis: assessment using a Rasch analysis approach2020In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 18, no 1, article id 168Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Fatigue is a common symptom associated with a wide range of diseases and needs to be more thoroughly studied. To minimise patient burden and to enhance response rates in research studies, patient-reported outcome measures (PROM) need to be as short as possible, without sacrificing reliability and validity. It is also important to have a generic measure that can be used for comparisons across different patient populations. Thus, the aim of this secondary analysis was to evaluate the psychometric properties of the Norwegian 5-item version of the Lee Fatigue Scale (LFS) in two distinct patient populations.

    METHODS: The sample was obtained from two different Norwegian studies and included patients 4-6 weeks after stroke (n = 322) and patients with osteoarthritis on a waiting list for total knee arthroplasty (n = 203). Fatigue severity was rated by five items from the Norwegian version of the LFS, rating each item on a numeric rating scale from 1 to 10. Rasch analysis was used to evaluate the psychometric properties of the 5-item scale across the two patient samples.

    RESULTS: Three of the five LFS items ("tired", "fatigued" and "worn out") showed acceptable internal scale validity as they met the set criterion for goodness-of-fit after removal of two items with unacceptable goodness-of-fit to the Rasch model. The 3-item LFS explained 81.6% of the variance, demonstrated acceptable unidimensionality, could separate the fatigue responses into three distinct severity groups and had no differential functioning with regard to disease group. The 3-item version of the LFS had a higher separation index and better internal consistency reliability than the 5-item version.

    CONCLUSIONS: A 3-item version of the LFS demonstrated acceptable psychometric properties in two distinct samples of patients, suggesting it may be useful as a brief generic measure of fatigue severity.

    TRIAL REGISTRATION: Clinicaltrials.gov: NCT02338869; registered 10/04/2014 (stroke study).

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  • 8.
    Forsström, David
    et al.
    Stockholm Univ, Dept Psychol, Stockholm, Sweden.;Karolinska Inst, Stockholm Hlth Care Serv, Ctr Psychiat Res, Dept Clin Neurosci, Stockholm, Sweden..
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Rozental, Alexander
    Karolinska Inst, Stockholm Hlth Care Serv, Ctr Psychiat Res, Dept Clin Neurosci, Stockholm, Sweden.;Uppsala Univ, Dept Psychol, Uppsala, Sweden.;UCL Great Ormond St Inst Child Hlth, London, England..
    Lindner, Philip
    Karolinska Inst, Stockholm Hlth Care Serv, Ctr Psychiat Res, Dept Clin Neurosci, Stockholm, Sweden.;Ctr Dependency Disorders, Stockholm Hlth Care Serv, Stockholm, Sweden..
    Jansson-Fröjmark, Markus
    Karolinska Inst, Stockholm Hlth Care Serv, Ctr Psychiat Res, Dept Clin Neurosci, Stockholm, Sweden..
    Carlbring, Per
    Stockholm Univ, Dept Psychol, Stockholm, Sweden..
    Psychometric properties of the Jonsson-Abbott Scale: Rasch and confirmatory factor analyses2022In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 13, article id 936685Article in journal (Refereed)
    Abstract [en]

    Measuring and assessing the different aspects of gambling behavior and its consequences is crucial for planning prevention, treatment, and understanding the development of at-risk and problem gambling. Studies indicate that instruments measuring problem gambling produce different results based on the characteristics of the population assessed. To accurately measure at-risk and problem gambling behavior, especially in a low-risk population, measures must cover a wider set of dimensions than the negative consequences already manifest. The Jonsson-Abbott Scale (JAS) includes items that cover overconsumption, actions that reinforce gambling behavior, and belief in gambling fallacies, based on a three-factor structure and has previously demonstrated good psychometric properties. However, there is a need to investigate how the instrument also functions in low-risk populations. This study aims to do so using both confirmatory factor and Rasch analysis; this research included 1,413 Swedish participants who endorsed at least one JAS item. The results replicated the previous three-factor solution and indicated that the instrument had good reliability. In addition, the results demonstrated that the three factors are independent, and the overall score per factor needs to be analyzed. In summary, the JAS appears suitable for use in low-risk populations to measure various aspects of gambling behavior.

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  • 9.
    Forsström, David
    et al.
    Stockholm University; Karolinska Institutet & Stockholm Health Care Services.
    Rozental, Alexander
    Karolinska Institutet & Stockholm Health Care Services; UCL, UK.
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Lindner, Philip
    Karolinska Institutet & Stockholm Health Care Services.
    Jansson-Fröjmark, Markus
    Karolinska Institutet & Stockholm Health Care Services.
    Hesser, Hugo
    Örebro University; Linköping University.
    Further Exploration of the Psychometric Properties of GamTest: A Rasch Analysis.2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 9, article id 4824Article in journal (Refereed)
    Abstract [en]

    GamTest is a self-rating scale of negative consequences of gambling, included in the popular responsible gambling tool Playscan as part of an overall risk assessment and feedback feature. Two previous psychometric evaluations of this instrument yielded contradictory results: in an online high-gambling population, a five-factor model was supported and the instrument had overall good psychometric properties, but in a low-gambling population, the same factor structure was not supported. Because GamTest is used with both low- and high-gambling populations, more psychometric research is needed to fully understand how the instrument works. The current study examined, for the first time, psychometric performance among a sample of low-gambling respondents using a Rasch analysis. Results indicated that the instrument could be improved by decreasing the scale-steps and removing several problematic items demonstrating misfit. Furthermore, the findings indicated that some items functioned differently depending on gender, and that a shortened, improved nine-item version could not differentiate between different levels of risk. Our findings suggest that the instrument would arguably benefit from being adapted for use in a low-gambling population.

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  • 10. Fridberg, Helena
    et al.
    Wallin, Lars
    Wallengren, Catarina
    Forsman, Henrietta
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Tistad, Malin
    Development of an instrument for evaluating implementation efforts and benchmarking regarding person centered care2020In: Implementation Science, E-ISSN 1748-5908, Vol. 15, no S1, article id A62Article in journal (Other academic)
  • 11. Fridberg, Helena
    et al.
    Wallin, Lars
    Wallengren, Catarina
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Forsman, Henrietta
    Tistad, Malin
    Development and evaluation of the measurement properties of a generic questionnaire measuring patient perceptions of person-centred care2020In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 20, no 1, article id 960Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Implementation of person-centred care (PCC) is a challenging undertaking. Thus, a call has been issued for a robust and generic instrument to measure and enable evaluation of PCC across settings and patient groups. This study aimed to develop a generic questionnaire measuring patients' perceptions of PCC. Further aims were to evaluate its content and measurement properties using a mixed-methods approach entailing Rasch and qualitative content analyses.

    METHODS: The study was conducted in three iterative phases. Phase one included six key informants to gain a broad view of the concept. Phase two entailed a Delphi study involving two rounds with eight experts who generated ratings on relevance, readability, comprehensiveness and suggestions for revision. Data were analysed using the Item Content Validity Index in conjunction with qualitative comments to improve the questionnaire. Phase three was performed using a mixed-methods design. Quantitative data were collected from patients (n = 553) responding to the questionnaire who were recruited from six in- and outpatient care units in a health care region in Sweden. Data was analysed using the Rasch measurement model. Qualitative data were based on the respondents' free-text comments, cognitive interviews (n = 10) and field notes, and then analysed with deductive content analysis.

    RESULTS: A questionnaire was developed and operationalised based on the information given by key informants in phase one and then validated for its content by experts in phase two. In phase three Rasch analyses revealed problems with targeting, thresholds and two misfitting items. These problems were corroborated by data from the qualitative analyses, which also revealed some issues of wording and interpretation of items. When thresholds were resolved and two items removed, the questionnaire met the assumptions of the Rasch model.

    CONCLUSIONS: Experts gave the questionnaire content high ratings and it met measurement requirements assumed by the Rasch model after revisions. Those problems on targeting that remain need to be addressed in future studies. Meanwhile, we regard the questionnaire as of sufficient quality to be useful in benchmarking PCC.

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  • 12.
    Fritzell, Kaisa
    et al.
    Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden; Hereditary Cancer Clinic, Theme Cancer, Karolinska University Hospital, Stockholm, Sweden.
    Hedberg, Berith
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Woudstra, Anke
    Team Advies en Onderzoek, Municipal Health Service (GGD) Kennemerland, Haarlem, the Netherlands.
    Forsberg, Anna
    Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
    Sventelius, Marika
    Regional Cancer Centre, Stockholm, Gotland, Sweden.
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Jervaeus, Anna
    Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden.
    Making the BEST decision-the BESTa project development, implementation and evaluation of a digital Decision Aid in Swedish cancer screening programmes- a description of a research project2023In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 12, article id e0294332Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Sweden has a long tradition of organized national population-based screening programmes. Participation rates differ between programmes and regions, being relatively high in some groups, but lower in others. To ensure an equity perspective on screening, it is desirable that individuals make an informed decision based on knowledge rather than ignorance, misconceptions, or fear. Decision Aids (DAs) are set to deliver information about different healthcare options and help individuals to visualize the values associated with each available option. DAs are not intended to guide individuals to choose one option over another. The advantage of an individual Decision Aid (iDA) is that individuals gain knowledge about cancer and screening by accessing one webpage with the possibility to communicate with health professionals and thereafter make their decision regarding participation. The objective is therefore to develop, implement and evaluate a digital iDA for individuals invited to cancer screening in Sweden.

    METHODS: This study encompasses a process-, implementation-, and outcome evaluation. Multiple methods will be applied including focus group discussions, individual interviews and the usage of the think aloud technique and self-reported questionnaire data. The project is based on The International Patient Decision Aid Standards (IPDAS) framework and the proposed model development process for DAs. Individuals aged 23-74, including women (the cervical-, breast- and CRC screening module) and men (the CRC screening module), will be included in the developmental process. Efforts will be made to recruit participants with self-reported physical and mental limitations, individuals without a permanent residence and ethnic minorities.

    DISCUSSION: To the best of our knowledge, the present study is the first attempt aimed at developing an iDA for use in the Swedish context. The iDA is intended to facilitate shared decision making about participation in screening. Furthermore, the iDA is expected to increase knowledge and raise awareness about cancer and cancer screening.

    PATIENT OR PUBLIC CONTRIBUTION: Lay people are involved throughout the whole development and implementation process of the digital DA.

    TRIAL REGISTRATION: NCT05512260.

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  • 13.
    Fritzell, Kaisa
    et al.
    Department of Neurobiology, Care Sciences and Society Karolinska Institutet Stockholm Sweden.
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Jervaeus, Anna
    Department of Neurobiology, Care Sciences and Society Karolinska Institutet Stockholm Sweden.
    Different information needs—The major reasons for calling the helpline when invited to colorectal cancer screening2022In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 25, no 4, p. 1548-1554Article in journal (Refereed)
    Abstract [en]

    Introduction: This study pertains to the design of a decision aid (DA) to shed light on information and support needs in colorectal cancer screening, with the aim to explore the calling patterns to the Screening of Swedish Colons (SCREESCO) study's helpline.

    Methods: A cross-sectional study was conducted with data from documented telephone calls to the SCREESCO study, including individuals, 59-60 years, randomized to colonoscopy or high sensitive faecal immunochemical test (FIT).

    Results: More than 2000 calls (women 58.5%; colonoscopy 59%) were analysed. Calling patterns: unsubscribing from screening, confirmation of participation, logistical concerns about the screening procedure, counselling, and FIT screening difficulties or in need of a new FIT test. Comorbidity was the most frequent reason for unsubscribing and most of the counselling calls included questions about the FIT test or the colonoscopy.

    Conclusion: Most of the calls to the helpline seemed to be related to individuals' lack of understanding about the organization of the screening programme and the screening procedure. Therefore, we find it important to further stress the tailoring part in our DA developing process, that is, provide limited information initially, with the possibility of access to more, if desired by the individual, still with respect to the individual's needs, health and digital literacy.

    Patient and public contribution: Individuals representing the public and invited to SCREESCO participated since we analysed their calls to the helpline. The findings will contribute to our continued work with the DA where the public will contribute and participate.

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  • 14.
    Gaber, S. N.
    et al.
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Nygård, L.
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Malinowsky, C.
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Brorsson, A.
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.
    Hedman, A.
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden; Research and Development, FoU Nordost, Danderyd, Sweden.
    Enacting citizenship through participation in a technological society: A longitudinal three-year study among people with dementia in Sweden2023In: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, Vol. 43, no 2, p. 276-297Article in journal (Refereed)
    Abstract [en]

    The role of Everyday Technology (ET) use is presented as subsidiary or neutral in policy for age- and dementia-friendly communities; and yet, research suggests that older people, especially those with dementia, experience increased challenges using ET in their everyday lives. Through the lens of micro-citizenship, the study aims to deepen the knowledge about how use of ET outside the home, including portable ETs, relates to participation in places visited within public space among people with dementia over time. Using a longitudinal study design, 35 people with dementia were recruited at baseline and followed over three years. Data were collected through semi-structured interviews using standardised questionnaires: the Participation in ACTivities and Places OUTside Home Questionnaire (ACT-OUT) and the Everyday Technology Use Questionnaire (ETUQ). Random intercept modelling and descriptive statistics were used to analyse the data. Throughout the three-year study, decreasing use of ET outside the home, including portable ETs, was associated with decreasing participation in places visited within public space, in a statistically significant way when controlling for age (F = 7.59, p = 0.01). The findings indicate that facilitating access and use of ET outside the home, among people with dementia, should be integral to promoting and maintaining participation in age- and dementia-friendly communities. Copyright © The Author(s), 2021. Published by Cambridge University Press.

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  • 15. Gaber, Sophie N
    et al.
    Nygård, Louise
    Brorsson, Anna
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Charlesworth, Georgina
    Wallcook, Sarah
    Malinowsky, Camilla
    Social Participation in Relation to Technology Use and Social Deprivation: A Mixed Methods Study Among Older People with and without Dementia2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 11, article id E4022Article in journal (Refereed)
    Abstract [en]

    = 0.033). The content analysis and graphical joint display revealed motivators, considerations that require extra attention, and strategies for managing social participation. The results underline how Everyday Technology use can be assistive to social participation but also the need to consider social deprivation of the living environment, especially among people with dementia.

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  • 16.
    Gaber, Sophie N.
    et al.
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Marie Cederschiöld University, Stockholm, Sweden.
    Nygård, Louise
    Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
    Brorsson, Anna
    Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Charlesworth, Georgina
    Research Department of Clinical, Educational and Health Psychology, UCL, United Kingdom.
    Wallcook, Sarah
    Stockholm Gerontology Research Centre, Sweden.
    Malinowsky, Camilla Walles
    Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
    Social participation and everyday technology use: A mixed-methods study among people living with and without dementia2022In: Improving the Lives of People with Dementia through Technology: Interdisciplinary Network for Dementia Utilising Current Technology / [ed] Martin Orrell, Déborah Oliveira, Orii McDermott, Frans R. J. Verhey, Fania C. M. Dassen, Rose-Marie Dröes, Routledge, 2022, p. 56-70Chapter in book (Refereed)
    Abstract [en]

    Social participation is a modifiable determinant for health and well-being among older people; however, social participation is increasingly dependent on technology use. This study investigated social participation in relation to Everyday Technology (ET) use and social deprivation of the living environment among older people with and without dementia in the United Kingdom. Sixty-four older people living with dementia and 64 older people without dementia were interviewed using The Participation in ACTivities and Places OUTside Home Questionnaire and Everyday Technology Use Questionnaire. A mixed-methods approach integrated statistical analyses and content analysis of free-text responses. Small, statistically significant positive associations were found between social participation and ET use outside home, for participants with dementia (Rs = 0.247; p = 0.049) and without dementia (Rs = 0.343; p = 0.006). A small statistically significant positive association was identified between social participation and the index of multiple deprivation in the living environment, among only participants living with dementia (Rs = 0.267, p = 0.033). The content analysis and graphical joint display revealed motivators, considerations that require extra attention, and strategies for managing social participation in relation to ET use. The mixed-methods synthesis revealed a nuanced view of ETs, as both useful in not only planning and preparatory activities but also challenging for social participation.

  • 17.
    Gaber, Sophie N.
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Stockholm, Sweden..
    Nygård, Louise
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Stockholm, Sweden..
    Brorsson, Anna
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Stockholm, Sweden..
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Malinowsky, Camilla
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Stockholm, Sweden..
    Everyday technologies and public space participation among people with and without dementia2019In: Canadian Journal of Occupational Therapy / Revue Canadienne d`Ergotèrapie, ISSN 0008-4174, Vol. 86, no 5, p. 400-411Article in journal (Refereed)
    Abstract [en]

    Background. Occupational therapists support everyday technology use; however, it is necessary to consider the challenges that people with dementia encounter with everyday technologies when participating in various places within public space. Purpose. The purpose of the study was to explore stability and change in participation in places visited within public space in relation to the relevance of everyday technologies used within public space. Method. People with dementia (n = 35) and people with no known cognitive impairment (n = 34) were interviewed using the Participation in Activities and Places Outside Home Questionnaire and the Everyday Technology Use Questionnaire. Data analysis used modern and classical test theory. Findings. Both samples participated in places within public space; however, participation and relevance of everyday technologies were significantly lower for the dementia group.

  • 18.
    Gaber, Sophie N.
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Alfred Nobels Alle 23, SE-14183 Huddinge, Sweden.;Marie Cederschiold Univ, Dept Hlth Care Sci, Stockholm, Sweden..
    Thalen, Liv
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Alfred Nobels Alle 23, SE-14183 Huddinge, Sweden..
    Malinowsky, Camilla W.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Alfred Nobels Alle 23, SE-14183 Huddinge, Sweden..
    Margot-Cattin, Isabel
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Alfred Nobels Alle 23, SE-14183 Huddinge, Sweden.;Univ Appl Sci & Arts Western Switzerland HES SO D, Sch Social Work & Hlth, Dept Occupat Therapy, Lausanne HETSL, Delemont, Switzerland..
    Seetharaman, Kishore
    Simon Fraser Univ, Dept Gerontol, Burnaby, BC, Canada..
    Chaudhury, Habib
    Simon Fraser Univ, Dept Gerontol, Burnaby, BC, Canada..
    Cutchin, Malcolm
    Pacific Northwest Univ Hlth Sci, Yakima, WA USA..
    Wallcook, Sarah
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Alfred Nobels Alle 23, SE-14183 Huddinge, Sweden..
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Alfred Nobels Alle 23, SE-14183 Huddinge, Sweden..
    Brorsson, Anna
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Alfred Nobels Alle 23, SE-14183 Huddinge, Sweden..
    Biglieri, Samantha
    Ryerson Univ, Sch Urban & Reg Planning, Toronto, ON, Canada..
    Nygard, Louise
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Occupat Therapy, Alfred Nobels Alle 23, SE-14183 Huddinge, Sweden..
    Social Citizenship Through Out-of-Home Participation Among Older Adults With and Without Dementia2022In: Journal of Applied Gerontology, ISSN 0733-4648, E-ISSN 1552-4523, Vol. 41, no 11, p. 2362-2373Article in journal (Refereed)
    Abstract [en]

    There is limited empirical knowledge about how older adults living with dementia enact their social citizenship through out-of-home participation. This study aimed: (a) to investigate out-of-home participation among older adults with and without dementia in four countries and (b) to compare aspects of stability or change in out-of-home participation. Using a cross-sectional design, older adults with mild-to-moderate dementia and without dementia, aged 55 years and over, were interviewed using the Participation in ACTivities and Places OUTside the Home questionnaire in Canada (n = 58), Sweden (n = 69), Switzerland (n = 70), and the United Kingdom (n = 128). Data were analyzed using descriptive statistics and a two-way analysis of variance. After adjustment for age, diagnosis of dementia and country of residence had significant effects on total out-of-home participation (p < .01). The results contribute to policies and development of programs to facilitate social citizenship by targeting specific activities and places.

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  • 19. Gaber, Sophie Nadia
    et al.
    Nygård, Louise
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Charlesworth, Georgina
    Wallcook, Sarah
    Malinowsky, Camilla
    Perceived risks, concession travel pass access and everyday technology use for out-of-home participation: cross-sectional interviews among older people in the UK2020In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 20, no 1, article id 192Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The health-promoting qualities of participation as an opportunity for social and cognitive engagement are well known. Use of Everyday Technology such as Smartphones or ATMs, as enabling or disabling factors for out-of-home participation is however under-researched, particularly among older people with and without dementia. Out-of-home participation involves participation in places and activities outside of a person's home, in public space. Situated within the context of an increasingly technological society, the study investigated factors such as perceived risks, access to a concession travel pass and use of Everyday Technologies, and their relationship with out-of-home participation, among older people in the UK.

    METHODS: One hundred twenty-eight older people with and without dementia in urban and rural environments in the UK, were interviewed using the Participation in ACTivities and Places OUTside Home (ACT-OUT) Questionnaire and the Everyday Technology Use Questionnaire (ETUQ). Associations between Everyday Technology use, perceived risk of falling, functional impairment, access to a concession travel pass and out-of-home participation were investigated using ordinal regression.

    RESULTS: A higher probability of Everyday Technology use (Odds Ratio [OR] = 1.492; 95% Confidence Interval [CI] = 1.041-1.127), perceived risk of falling outside home (OR = 2.499; 95% CI = 1.235-5.053) and, access to a concession travel pass (OR = 3.943; 95% CI = 1.970-7.893) were associated with a higher level of out-of-home participation. However, other types of risk (getting lost; feeling stressed or embarrassed) were not associated with out-of-home participation. Having a functional impairment was associated with a low probability of a higher level of out-of-home participation (OR = .470; 95% CI = .181-1.223). Across the sample, 'outside home' Everyday Technologies were used to a higher degree than 'portable' Everyday Technologies which can be used both in and outside home.

    CONCLUSIONS: The study provides insights into perceived risks, access to a concession travel pass and use of Everyday Technologies, and their relationship with out-of-home participation, among older people in the UK. Increased knowledge about factors associated with out-of-home participation may help to guide targeted health and social care planning.

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  • 20.
    Granbom, Marianne
    et al.
    Department of Health Sciences, Lund University, Lund, Sweden.
    Jönson, Håkan
    School of Social Work, Lund University, Lund, Sweden.
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Older Adults Living in Disadvantaged Areas: Protocol for a Mixed Methods Baseline Study on Homes, Quality of Life, and Participation in Transitioning Neighborhoods2022In: JMIR Research Protocols, E-ISSN 1929-0748, Vol. 11, no 10, p. 1-10, article id e41255Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Swedish policy states that older adults should be able to age safely with continued independence and lead active lives. However, this plays out differently in different Swedish municipalities depending upon degree of demographic change, globalization, and urbanization. Internationally, older adults living in disadvantaged areas have worse physical and mental health, activity restrictions, and reduced life expectancy. In Sweden, research on how disadvantaged areas impact older adults' quality of life is virtually nonexistent. We argue that disadvantaged areas exist in both urban and rural contexts.

    OBJECTIVE: We aimed to investigate how older adults' homes and neighborhoods influence their community participation, quality of life, identity, and belonging in urban and rural disadvantaged areas in Sweden, and how these person-context dynamics are experienced by older adults in transitioning neighborhoods.

    METHODS: The study has a mixed methods design and includes 3 phases. Adults 65 years and older living in certain urban and rural disadvantaged areas in the south of Sweden will be included. Phase 1 is an interview study in which qualitative data are collected on neighborhood attachment, identity, and belonging through semistructured interviews and photo-elicitation interviews with 40 subjects. A variety of qualitative data analysis procedures are used. In phase 2, a survey study will be conducted to explore associations between observable and self-rated aspects of housing and neighborhood (physical, social, and emotional), participation, and quality of life; 400 subjects will be recruited and added to the 40 phase-1 subjects for a total of 440. The survey will include standardized measures and study-specific questions. Survey data will be analyzed with mainstream statistical analyses and structural equation modeling to understand the interactions between quality of life, home and neighborhood factors, and sociodemographic factors. In phase 3, the integration study, survey data from the 40 participants who participated in both data collections will be analyzed together with qualitative data with a mixed methods analysis approach.

    RESULTS: As of the submission of this protocol (August 2022), recruitment for the interview study is complete (N=39), and 267 participants have been recruited and have completed data collection in the survey study. We expect recruitment and data collection to be finalized by December 2022.

    CONCLUSIONS: With an increasing proportion of older adults, an increasing number of disadvantaged areas, and an increasing dependency ratio in more than 50% of Swedish municipalities, these municipalities are transforming and becoming increasingly segregated. This study will add unique knowledge on what it is like to be older in a disadvantaged area and deepen knowledge on housing and health dynamics in later life. Further, the design of the current study will allow future follow-up studies to facilitate longitudinal analysis (if funding is granted) on aging in a transforming societal context.

    INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/41255.

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  • 21.
    Hahn, Bridget
    et al.
    Rush University Medical Center, Chicago, IL, USA.
    Fisher, Heidi
    University of Illinois Chicago, USA.
    Hansen, Piper
    Rush University Medical Center, Chicago, IL, USA.
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Feasibility of Increasing Occupation-Based Assessment Using the Knowledge to Action Framework2023In: OTJR (Thorofare, N.J.), ISSN 1539-4492, E-ISSN 1938-2383, Vol. 43, no 4, p. 645-654, article id 15394492221137377Article in journal (Refereed)
    Abstract [en]

    The Assessment of Motor and Process Skills (AMPS) is a standardized occupation-based measure; however, barriers often limit use in practice. The Knowledge to Action Framework (KTA) is one of the most widely used implementation approaches to induce practice change. The objective of the study is to examine the feasibility and acceptability of a KTA-informed intervention to increase the use of the AMPS. AMPS-trained occupational therapists were recruited through convenience sampling. Interventions included workshops, action planning, goal setting, peer support, and organizational resources. Recruitment and retention were tracked. Pre- and post-survey results of interventions’ helpfulness, AMPS behaviors, and motivational changes informed acceptability. Participants (n = 5) rated 7/7 (100%) intervention strategies as helpful, reported decreased barriers and increased frequency of AMPS administration, increased resources for AMPS implementation, and improved compatibility with practice. Implementation of a KTA-informed intervention to increase AMPS practice was feasible and supported by environmental changes and peer support in a physical rehabilitation setting. 

  • 22. Hedman, Annicka
    et al.
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Almkvist, Ove
    Nygård, Louise
    Challenge levels of everyday technologies as perceived over five years by older adults with mild cognitive impairment2018In: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 30, no 10, p. 1447-1454Article in journal (Refereed)
    Abstract [en]

    Background: In clinical practice, efficient and valid functional markers are needed to detect subtle cognitive and functional decline in mild cognitive impairment (MCI). This prospective study explored whether changes in perceived challenge of certain everyday technologies (ETs) can be used to detect signs of functional change in MCI. Methods: Baseline and five-year data from 37 older adults (mean age 67.5 years) with MCI regarding their perceived ability to use ET were used to generate Rasch-based ET item measures reflecting the relative challenge of 46 ETs. Actual differential item functioning in relation to time was analyzed based on these item measures. Data collection took place in 2008-2014. Results: Seven (15%) of the ETs included were perceived to be significantly more challenging to use at year five compared to at baseline, while 39 ETs (85%) were perceived to be equally challenging to use, despite the fact that the participants' perceived ability to use ET had decreased. Common characteristics among the ETs that became more challenging to use could not be identified. The dropout rate was 43%, which limits the power of the study. Conclusions: Changes in the perceived challenge of ETs seem to capture functional change in persons with cognitive decline. Both easier and more challenging ETs typically used at home and in society need to be addressed to capture this functional change because significant changes occurred among ETs of all challenge levels and within all types of ETs.

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  • 23.
    Helle, Tina
    et al.
    University College North, Aalborg, Denmark; Karolinska Institutet.
    Joho, Tanja
    Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.
    Kaptain, Rina Juel
    University College North, Aalborg, Denmark; Karolinska Institutet.
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Karolinska Institutet.
    Activity repertoires and time use in people living with chronic obstructive pulmonary disease2021In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 8, no 7, p. 564-570Article in journal (Refereed)
    Abstract [en]

    Background:Understanding the dynamics and aspects of how activity choices impact health and well-being in people living with chronic obstructive pulmonary disease (COPD) is important to inform rehabilitation. Aim:To describe, firstly, how much time people living with COPD spend on work, daily living tasks, recreation and rest; secondly, how this population perceived competence, importance and enjoyment related to these activities; thirdly, if differences in such perceptions and time use were associated with the living situation and COPD severity. Material and methods:This cross-sectional study involved 76 participants (+45 years, COPD, living in ordinary homes), who completed the Occupational Questionnaire (OQ). Descriptive statistics and group comparisons were performed. Results:Most of the participants' time were spent on daily living activities and recreational activities. Participants spent approx. 80% of their recorded time in OQ on activities they valued, enjoyed and in which they felt competent. Participants living alone scored significantly lower on enjoyment in restful activities than those living in couples (p < 0.05). No statistically significant difference in perceived competence, importance or enjoyment was found in relation to COPD severity. Conclusions and significance:Findings underscore the importance of targeting overall daily activity repertoires including compositions of activity types, time use and perceived competence, importance and enjoyment.

  • 24. Jakobsson, Elin
    et al.
    Nygard, Louise
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Malinowsky, Camilla
    Experiences from using eHealth in contact with health care among older adults with cognitive impairment2019In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 33, no 2, p. 380-389Article in journal (Refereed)
    Abstract [en]

    RATIONALE: Since health care is facing challenges, with fewer caregivers providing care to more clients, eHealth plays a crucial role. Through eHealth, people are expected to be more involved in their own care. On the part of health care users, eHealth requires use of everyday technology such as telephones and computers, and services through the Internet which might be challenging for older adults with cognitive impairment. AIM: To investigate experiences of using eHealth in contact with health care among older adults with cognitive impairment. METHOD: Individual, semi-structured interviews were conducted with nine participants, aged 65-84 years, with cognitive impairments of varying origins. A constructivist Grounded Theory approach was used. Data collection and analysis were performed simultaneously using a constant comparative method. ETHICAL ISSUES: Ethical approval (Dnr: 2014/906-32) was obtained from the regional ethical committee, Stockholm. RESULTS: The core category, the eHealth staircase supported by habits, is presented as a model that visualises the result. The model includes three steps showing different ways of being in contact with health care through the use of technological devices and services that mirrors different levels of complexity of eHealth use as follows: (i) Analogue use, (ii) One-way-use and (iii) Interactive use. The participants' location on the eHealth staircase was affected by several aspects described in three categories united by habits; A stable relationship with technology: a prerequisite for use; The importance of interpersonal relationships within health care and Being supported by significant others: a prerequisite in contact with health care. CONCLUSIONS: Older adults with cognitive impairments seemed to prefer common and less complex eHealth when contacting health care. Therefore, it is necessary that health care providers offer different possibilities for patients to contact them, that is, both through the Internet and by personal telephone service.

  • 25.
    Jakobsson, Elin
    et al.
    Karolinska Institutet.
    Nygard, Louise
    Karolinska Institutet.
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Olsson, Cecilia Brakenhielm
    Karolinska University Hospital.
    Malinowsky, Camilla
    Karolinska Institutet.
    The use of everyday technology; a comparison of older persons with cognitive impairments' self-reports and their proxies' reports2021In: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, Vol. 84, no 7, p. 446-455, article id 0308022620954117Article in journal (Refereed)
    Abstract [en]

    Introduction Older persons with cognitive impairment have often been disregarded in providing information on their own perceptions. This study explored the number of relevant everyday technologies and the ability to use everyday technologies as perceived by persons with cognitive impairment in comparison with their proxies' estimates using the Short Everyday Technology Use Questionnaire. Method In this cross-sectional study, persons with cognitive impairment (n = 21) and their proxies (n = 21) were interviewed on separate occasions with the Short Everyday Technology Use Questionnaire, which measures the number of relevant everyday technologies and the ability to use everyday technologies. The data were analysed with t-tests, z-comparisons, and Fisher's exact test. The level of significance was set at p < 0.05. Results At the group level, no significant differences were found between persons with cognitive impairments' perceptions and their proxies' estimates regarding the number of relevant everyday technologies or the ability to use everyday technologies. On the individual level, significant differences were found in the ability measures within four out of the 21 dyads. Conclusion The persons with cognitive impairment and their proxies verified each other's responses, providing evidence that persons with cognitive impairment should be the primary source for information about their own everyday technology use.

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  • 26.
    Jakobsson, Elin
    et al.
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Nygård, Louise
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Bråkenhielm Olsson, Cecilia
    Allied Health Porfessionals Function, Karolinska University Hospital, Huddinge, Sweden.
    Malinowsky, Camilla
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Does the purpose matter? A comparison of everyday information and communication technologies between eHealth use and general use as perceived by older adults with cognitive impairment.2022In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 17, no 8, p. 897-906Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND OBJECTIVE: Everyday information and communication technologies (EICTs) are increasingly being used in our society, for both general and health-related purposes. This study aims to compare how older adults with cognitive impairment perceive relevance and level of EICT challenge between eHealth use and general use.

    METHODS:  < .05.

    RESULTS: The result shows that the perceived amount of relevant EICTs for eHealth use was lower in all 16 EICTs compared to those of general use. About the perceived level of challenge, a significant difference was detected in one of the seven included EICTs between eHealth use and general use.

    CONCLUSIONS: In this sample, all EICTs were perceived as having lower relevance for eHealth use compared to general use, suggesting that the purpose of using an EICT affects the perceived relevance of it. Also, once an EICT is perceived as relevant and used for eHealth purposes, there seem to be little to no differences in perceived challenge compared to the same EICT used for general purposes. Implications for rehabilitation All stakeholders, including health care providers, need to be aware of the hindrances that come with digitalization, making it challenging to many citizens to make use of digital solutions. It is of great importance that social services including eHealth services be tailored to suit the individual/target group. Older adults may need support and an introduction to EICTs to discover the potential relevance of the specific device and/or service.

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  • 27. Jervaeus, Anna
    et al.
    Fritzell, Kaisa
    Hultcrantz, Rolf
    Wengström, Yvonne
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Psychometric properties of the SCREESCO questionnaire used in a colorectal cancer screening programme-A Rasch analysis.2020In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 26, no 2, p. 541-550Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Colorectal cancer (CRC) is one of the most common cancer diagnoses among both sexes. Sweden has not yet implemented any CRC screening programme, but a study, Screening of Swedish Colons (SCREESCO), is ongoing. The movement within the health care sector towards a more participatory perspective has led to the increased importance of shared decision making (SDM), and this is suggestively applied when deciding upon screening participation. There is no Swedish questionnaire for assessing the level of SDM in relation to CRC screening. Therefore, the CRC screening module of the National Survey of Medical Decisions was translated and culturally adapted into a Swedish context: the SCREESCO questionnaire. AIM: The SCREESCO questionnaire requires further evaluation, and therefore, the aim, by using the Rasch approach, was to evaluate the psychometric properties of the SCREESCO questionnaire. METHODS: A Rasch partial credit model was chosen to investigate the psychometric properties. The sample consisted of individuals invited to the SCREESCO programme, who have answered the SCREESCO questionnaire. RESULTS: Rating scale structures indicated stability for the response structure used. Satisfactory evidence for validity of internal structure was also shown for the whole questionnaire and two of three concepts/subscales, after deletion of a few items. Validity in response processes indicated acceptable, or close to acceptable, findings, while the results for unidimensionality and differential item functioning (DIF) were somewhat mixed. Separation index revealed less satisfactory results, both for the whole questionnaire and the concepts/subscales. CONCLUSION: This Rasch analysis of the SCREESCO questionnaire revealed that the questionnaire in its current form has difficulties to assess the level of SDM in relation to CRC screening. The achieved results will guide further evaluation and development with the long-term goal of having a Swedish questionnaire, to be used in the health care sector, assessing the level of SDM in relation to CRC screening.

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  • 28.
    Kaptain, Rina Juel
    et al.
    Department of Occupational Therapy, University College of Northern Denmark, Aalborg, Denmark; Department of Neurobiology, Care Science and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
    Helle, Tina
    Department of Occupational Therapy, University College of Northern Denmark, Aalborg, Denmark; Department of Neurobiology, Care Science and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Department of Neurobiology, Care Science and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
    Patomella, Ann-Helen
    Department of Neurobiology, Care Science and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
    Juggling the management of everyday life activities in persons living with chronic obstructive pulmonary disease2022In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 44, no 14, p. 3410-3421Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Evidence regarding everyday life activities in people living with COPD is limited. Such evidence can improve our understanding when designing interventions for pulmonary rehabilitation that aim at increasing or maintaining participation in these activities. The aim of this study was to describe how people living with COPD experience and manage everyday life activities.

    MATERIALS AND METHODS: The sample comprised four males and four females with an age ranging from 65-87 years. Participants were interviewed in their own homes regarding experiences of performing and managing everyday life activities. Data were transcribed verbatim and analysed using content analysis.

    RESULTS: Findings from this study comprised the theme "Juggling to manage everyday life activities with COPD" and three categories representing the elements of this theme: (1) consequences of COPD symptoms, (2) adjustment of activities, and (3) contextual aspects.

    CONCLUSION: This study found the participants with COPD juggling the management of everyday life activities. The juggle generated a manageable daily life, which came at the expense of making deliberate choices and prioritizing everyday life activities that were necessary for participation in valued and engaging activities in order to maintain health and well-being. Implications for Rehabilitation People living with COPD experience a complex juggling between the consequences of COPD symptoms and contextual aspects when managing everyday life activities. The participants had largely accepted their disease and adjusted to their situation. The disease was still described as frustrating and generated less focus on making deliberate choices and prioritizing everyday life activities that are necessary for participation in valued and engaging activities. Health professionals need to support people living with COPD in making deliberate choices in order to continue participating in valued and engaging everyday life activities as they affect health and well-being. Pulmonary rehabilitation should focus more on supporting participation in social relations and on using everyday technologies.

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  • 29. Kaptain, Rina Juel
    et al.
    Helle, Tina
    Patomella, Ann-Helen
    Weinreich, Ulla Møller
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Association Between Everyday Technology Use, Activities of Daily Living and Health-Related Quality of Life in Chronic Obstructive Pulmonary Disease2020In: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 15, p. 89-98Article in journal (Refereed)
    Abstract [en]

    Purpose: A decline in the ability to perform activities of daily living (ADL) and ability to use everyday technology can pose threats to independent living, healthcare management and quality of life (QOL) of patients suffering from chronic obstructive pulmonary disease (COPD). Evidence of the relationship between these variables remains limited. The dual aim of this study was, first, to investigate if health-related QOL (HRQOL) was associated with quality in ADL performance and everyday technology use; second, to examine whether lung function, years with COPD diagnosis, living status or educational level affected physical and mental domains of HRQOL. Methods: This cross-sectional study included (N=80) participants aged 46-87 years recruited at healthcare centres in the Northern Region of Denmark using a convenience sampling procedure. Data were gathered through standardized assessments and analysed using multiple regression analysis. Results: The regression model explained 50.6% (R2=0.506) of the variation in HRQOL-physical. The following four variables were statistically significantly associated with HRQOL - physical: years since COPD diagnosis (p=0.023), ability to use everyday technology (p=0.006), amount of relevant everyday technologies (p=0.015) and ADL motor ability (p<0.01). The regression model explained 22.80% (R-2=0.228) of HRQOL - mental. Only the variable ability to use everyday technology was statistically significantly associated with HRQOL - mental (p=0.009). Conclusion: Quality of ADL performance and everyday technology use seem to be associated with HRQOL in people living with COPD. The only demographic variable associated with HRQOL was years with COPD. This indicates that healthcare professionals should enhance their attention also to ADL-performance and everyday technology use when striving to increase the HRQOL of persons living with COPD.

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  • 30.
    Kaptain, Rina Juel
    et al.
    Department of Occupational Therapy, University College of Northern Denmark, Aalborg, Denmark; Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
    Helle, Tina
    Department of Occupational Therapy, University College of Northern Denmark, Aalborg, Denmark; Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
    Patomella, Ann-Helen
    Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
    Weinreich, Ulla Møller
    Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark; The Clinical Institute, Aalborg University, Aalborg, Denmark.
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.
    New Insights into Activities of Daily Living Performance in Chronic Obstructive Pulmonary Disease2021In: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 16, p. 1-12Article in journal (Refereed)
    Abstract [en]

    Purpose: There have been calls for more knowledge of activities of daily living (ADL) performance in order to address interventions in pulmonary rehabilitation effectively. Everyday technology (ET) has become an integrated dimension of ADL, impacting the ways in which ADL is performed. To improve everyday functioning and quality of life, the use of ADL and ET use needs to be evaluated and addressed effectively in interventions. Therefore, the aim of this study was twofold: 1) to explore the quality of ADL performance, and 2) to investigate the relationship between observation and self-reported ADL performance and ability to use everyday technologies in people living with COPD.

    Methods: This cross-sectional study involved 84 participants aged 46-87 years. Participants were recruited through healthcare centres in the Northern Region of Denmark using a convenience sampling procedure. Data were collected using standardized assessments that investigated different ADL perspectives: self-reported ADL tasks and ET use, observed motor and process ability, and need for assistance. Data were analysed and presented using descriptive statistics and Pearson's correlation coefficient.

    Results: The most affected ADL tasks were mobility within or outside the home, lower dressing, bathing, pedicuring, cooking, shopping, cleaning and washing clothes. New insights into the quality of ADL performance in people living with COPD were presented in terms of detailed ADL motor skills and ADL process skills, as well as the predicted need for support to function in the community. Moreover, new insights into the relationship between observation and self-reported ADL performance (r=0.546, p<0.01; r=0.297, p<0.01) and between ADL performance and self-perceived ability to use ET (r=0.524, p<0.01; r=0.273, p<0.05; r=0.044, p=0.692) were presented.

    Conclusion: Overall, the knowledge from the present study is valuable for focusing interventions that address challenging ADL performance and ET use through relevant and realistic activities. The ability to use ET is important to evaluate and target pulmonary rehabilitation.

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  • 31.
    Kottorp, Anders
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Keehn, Mary
    Hasnain, Memoona
    Gruss, Valerie
    Peterson, Elizabeth
    Instrument Refinement for Measuring Self-Efficacy for Competence in Interprofessional Collaborative Practice: Development and Psychometric Analysis of IPECC-SET 27 and IPECC-SET 92019In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 33, no 1, p. 47-56Article in journal (Refereed)
    Abstract [en]

    Assessing competence in interprofessional collaborative practice (ICP) among health professions students is a high priority. This cross-sectional study built on the authors' prior work that led to the development of the 38-item Interprofessional Education Collaborative Competency Self Efficacy Tool (IPECC-SET), an instrument to evaluate health professions students' self-efficacy in interprofessional collaborative competency, and addressed two primary questions. First, could a unidimensional scale based on the IPEC competencies and assessing perceived self-efficacy for competence in ICP and be constructed? Second, could a shorter version of that instrument still meet criteria for unidimensionality and retain the ability to separate students in distinct levels of perceived self-efficacy for competence in ICP? Study participants were two cohorts of students from 11 health professions programs participating in an institutional interprofessional immersion event in 2015 and 2016. Statistical stepwise analyses were conducted using a Rasch rating scale model. The original 38 IPECC-SET items did not meet the criteria to generate a valid unidimensional measure of self-efficacy for competence in ICP, but could be condensed into a 27-item scale that met all set criteria for unidimensionality, with an explained variance of 61.2% and a separation index of 3.02. A shorter, 9-item scale demonstrated a separation index of 2.21. The nine items included also demonstrated a relatively equivalent range (54.93-45.65) as compared to the 27-item scale (57.26-46.16). Findings confirm empirically the conceptual suggestion from our earlier work that the four dimensions in the original IPEC competencies contribute to a shared underlying construct: perceived competence in interprofessional collaboration. Given the emphasis on ICP, psychometrically sound instruments are needed to evaluate the effectiveness of educational efforts to promote competency for ICP. Based on the findings from this study, both the IPECC-SET 27 and IPECC-SET 9 can be used to measure perceived self-efficacy for competence in ICP.

  • 32.
    Kottorp, Anders
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Killian, Catherine
    Occupational Therapy Program, Midwestern University, Downers Grove, IL..
    Duke, Kathryn
    Occupational Therapy Programs, West Coast University, Center for Graduate Studies, Los Angeles, CA..
    Leggett, Caniece
    Franciscan Health, Olympia Fields, IL.; Department of Occupational Therapy, College of Applied Health Sciences, University of Illinois at Chicago..
    Drasga, Ruxandra
    Community First Medical Center, Chicago, IL.; Department of Occupational Therapy, College of Applied Health Sciences, University of Illinois at Chicago..
    Preissner, Katharine
    Department of Occupational Therapy, College of Applied Health Sciences, University of Illinois at Chicago..
    The Revised American Occupational Therapy Association Fieldwork Performance Evaluations: Evaluation of Internal Structure, Response Processes, and Precision—Part 22023In: American Journal of Occupational Therapy, ISSN 0272-9490, E-ISSN 1943-7676, Vol. 77, no 5Article in journal (Refereed)
    Abstract [en]

    Importance: There is an evidence-based need to assess the validity and reliability/precision of the revised American Occupational Therapy Association’s Fieldwork Performance Evaluation (FWPE) items for the occupational therapy student (OTS) and the occupational therapy assistant student (OTAS).

    Objective: To evaluate evidence of validity in relation to response processes, internal structure, and precision of the FWPEs.

    Design: Cross-sectional study design.

    Setting: OTS and OTAS fieldwork practice settings, United States.

    Participants: Two hundred sixty-seven fieldwork educators participated in total, providing 228 OTS evaluations and 39 OTAS evaluations.

    Outcomes and Measures: A Rasch model was used to evaluate aspects of validity and precision.

    Results: The rating scales provided evidence of the tools’ overall validity. Thirty-two of 37 items on the FWPE for the OTS, and 27 of 31 items on the FWPE for the OTAS demonstrated acceptable fit, but the evidence of unidimensionality in the subscales and in the total scales was not fully supported. The total/reduced FWPE scales were able to separate students into at least four distinct groups of fieldwork performance. The relationships between the current and revised FWPEs indicate that the new scales measure different but related constructs of student fieldwork performance, compared with the current version.

    Conclusions and Relevance: The findings support that the revised FWPEs for the OTS and OTAS demonstrate preliminary evidence of internal structure, response processes, and precision, supporting evidence-based practice in fieldwork evaluations.

    What This Article Adds: This article highlights evidence demonstrating the validity and precision of the revised American Occupational Therapy Association’s Fieldwork Performance Evaluation items and supports academic and fieldwork settings for occupational therapy students and occupational therapy assistant students.

  • 33. Köttl, Hanna
    et al.
    Fallahpour, Mandana
    Hedman, Annicka
    Nygård, Louise
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Depression, everyday technology use and life satisfaction in older adults with cognitive impairments: a cross-sectional exploratory study2021In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 35, no 1, p. 233-243Article in journal (Refereed)
    Abstract [en]

    RATIONAL: Life satisfaction is strongly associated with participation in everyday life activities. Yet, older adults with cognitive impairments have been found to experience difficulties in accessing and engaging in more complex everyday activities, especially, if these involve everyday technology. Considering the rapidly advancing technological landscape, this may substantially affect individuals' life satisfaction and their participation in meaningful community-based and home-based activities.

    OBJECTIVES: This study aimed to explore the associations between life satisfaction, ability to use everyday technology and number of relevant everyday technologies used in older adults (n = 117) with and without mild cognitive impairment (MCI) and Alzheimer's disease (AD). It also aimed to understand the role of depression, activity involvement and diagnosis regarding life satisfaction in this sample.

    METHOD: Descriptive statistics, Mann-Whitney U tests and t-tests were applied to compare those satisfied and those dissatisfied with life regarding ability to use everyday technology and number of relevant everyday technologies used.

    FINDINGS: The number of relevant community-based everyday technologies currently not used was significantly associated with being dissatisfied with life (p < 0.05). Further, depression and withdrawal from activities and interests significantly differed across life satisfaction groups, while no group differences were found regarding overall number of everyday technologies in use and ability to use everyday technology.

    CONCLUSION: Attention from healthcare professionals and researchers to early withdrawal from activities that rely on community-based everyday technologies is called for, especially in older adults with depression. Preventing everyday technology-related barriers in community life may increase life satisfaction.

  • 34.
    Lerdal, Anners
    et al.
    Research Department, Lovisenberg Diaconal Hospital, Oslo, Norway; Department of Interdisciplinary Health Sciences, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.
    Gay, Caryl
    Department of Interdisciplinary Health Sciences, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway; Department of Family Health Care Nursing, University of California, San Francisco, USA.
    Bonsaksen, Tore
    Department of Health and Nursing, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway; Department of Health, Faculty of Health Studies, VID Specialized University, Stavanger, Norway.
    Ekeberg, Øivind
    Psychosomatic and CL Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
    Grimholt, Trine
    Department of Health, Faculty of Health Studies, VID Specialized University, Oslo, Norway; Department of Acute Medicine, Oslo University Hospital, Oslo, Norway.
    Heir, Trond
    Norwegian Center for Violence and Traumatic Stress Studies, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Lee, Kathryn A
    Department of Family Health Care Nursing, University of California, San Francisco, USA.
    Skogstad, Laila
    Faculty of Health Sciences, Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
    Schou-Bredal, Inger
    Department of Public Health Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.
    Validation of a short version of the Lee fatigue scale in adults living in Norway: a cross-sectional population survey2023In: BMC Public Health, E-ISSN 1471-2458, Vol. 23, no 1, article id 2132Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Due to the nature of fatigue, a brief reliable measure of fatigue severity is needed. Thus, the aim of our study was to evaluate a short version of the Lee Fatigue Scale (LFS) in the Norwegian general population.

    METHODS: This cross-sectional survey consists of a representative sample from the Norwegian population drawn by The National Population Register in Norway. The study is part of a larger study (NORPOP) aimed at collecting normative data from several questionnaires focused on health in adults living in Norway. Registered citizens between 18 and 94 years of age were randomly selected stratified by age, sex and geographic region. Of the 4971 respondents eligible for the study, 1792 (36%) responded to the survey. In addition to age and sex, we collected responses on a 5-item version of the LFS measuring current fatige severity. The psychometric properties focusing on internal structure and precision of the LFS items were analyzed by a Rasch rating scale model.

    RESULTS: Complete LFS scores for analyses were available for 1767 adults. Women had higher LFS-scores than men, and adults < 55 years old had higher scores than older respondents. Our analysis of the LFS showed that the average category on each item advanced monotonically. Two of the five items demonstrated misfit, while the three other items demonstrated goodness-of-fit to the model and uni-dimensionality. Items #1 and #4 (tired and fatigue respectively) showed differential item functioning (DIF) by sex, but no items showed DIFs in relation to age. The separation index of the LFS 3-item scale showed that the sample could be separated into three different groups according to the respondents' fatigue levels. The LFS-3 raw scores correlated strongly with the Rasch measure from the three items. The core dimensions in these individual items were very similarly expressed in the Norwegian language version and this may be a threat to the cultural-related or language validity of a short version of the LFS using these particular items.

    CONCLUSIONS: The study provides validation of a short LFS 3-item version for estimating fatigue in the general population.

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  • 35.
    Lindsjö, Cecilia
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Sjögren Forss, Katarina
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kumlien, Christine
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Rämgård, Margareta
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Migrant women's engagement in health-promotive activities through a women's health collaboration2023In: Frontiers In Public Health, ISSN 2296-2565, Vol. 11, article id 1106972Article in journal (Refereed)
    Abstract [en]

    Introduction: Social determinants of health impact health, and migrants are exposed to an inequitable distribution of resources that may impact their health negatively, leading to health inequality and social injustice. Migrant women are difficult to engage in health-promotional activities because of language barriers, socioeconomic circumstances, and other social determinants. Based on the framework of Paulo Freire, a community health promotion program was established in a community-academic partnership with a community-based participatory research approach.

    Aim: The aim of this study was to describe how a collaborative women's health initiative contributed to migrant women's engagement in health promotion activities.

    Materials and methods: This study was part of a larger program, carried out in a disadvantaged city area in Sweden. It had a qualitative design with a participatory approach, following up on actions taken to promote health. Health-promotional activities were developed in collaboration with a women's health group, facilitated by a lay health promoter. The study population was formed by 17 mainly Middle Eastern migrant women. Data was collected using the story-dialog method and the material was analyzed using thematic analysis.

    Result: Three important contributors to engagement in health promotion were identified at an early stage of the analysis process, namely, the group forming a social network, the local facilitator from the community, and the use of social places close to home. Later in the analysis process, a connection was made between these contributors and the rationale behind their importance, that is, how they motivated and supported the women and how the dialog was conducted. This therefore became the designated themes and were connected to all contributors, forming three main themes and nine sub-themes.

    Conclusion: The key implication was that the women made use of their health knowledge and put it into practice. Thus, a progression from functional health literacy to a level of critical health literacy may be said to have occurred.

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  • 36. Malinowsky, Camilla
    et al.
    Nygård, Louise
    Pantzar, Monica
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Test-retest reliability of the short version of the everyday technology use questionnaire (S-ETUQ).2020In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 27, no 8, p. 567-576Article in journal (Refereed)
    Abstract [en]

    Background: Everyday technologies (ET) such as smart phones, and internet banking are increasingly incorporated into daily activities. Therefore, valid assessments are needed to identify ability in ET use and to design and evaluate interventions.

    Aims: To evaluate and compare the stability over time (test-retest reliability) of measures generated with the short version of the Everyday Technology Use Questionnaire (S-ETUQ) in older adults with cognitive impairment or mild dementia.

    Materials and Methods: Data was collected with S-ETUQ at two occasions (m = 20.9 days in between) in a sample of (n = 73) older adults with cognitive impairment of different origin (n = 38) or mild dementia (n = 35). Stability of each participant’s S-ETUQ measure was examined using standardised difference z-comparisons. The test-retest reliability coefficient of the S-ETUQ measures was determined by Intraclass Correlation Coefficients. Comparisons were performed using Mann-Whitney u-tests.

    Results: The S-ETUQ measures were statistically stable between the two occasions. Hence, the group of persons with cognitive impairment demonstrated slightly higher stability and fewer differences compared to the group with mild dementia. The ICCs (0.82–0.90) indicated good to excellent agreement.

    Conclusions: S- ETUQ can be used with older people with cognitive impairments of varying degree to gather reliable and precise information regarding their use of ET.

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  • 37. Margot-Cattin, Isabel
    et al.
    Kuhne, Nicolas
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Cutchin, Malcolm
    Öhman, Annika
    Nygård, Louise
    Development of a Questionnaire to Evaluate Out-of-Home Participation for People With Dementia2019In: American Journal of Occupational Therapy, ISSN 0272-9490, E-ISSN 1943-7676, Vol. 73, no 1, p. 7301205030p1-7301205030p10, article id 7301205030Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE. We describe the development of a questionnaire, Participation in Activities and Places Outside Home (ACT-OUT). for older adults with cognitive impairment and align it to people with mild- to moderate-stage dementia. METHOD. ACT-OUT was developed in a cross-cultural collaboration in combination with three rounds of cognitive interviews in Switzerland with 26 older adults without cognitive impairment and five older adults with dementia. Qualitative data from the interviews were analyzed using a constant comparison approach. RESULTS. The final ACT-OUT Version 1.0 consists of three parts: (1) questions targeting places older adults visit: (2) questions on aspects influencing participation , such as transportation. familiarity, and risk perception: and (3) questions on perception of self. CONCLUSION. The development of an instrument such as ACT-OUT is more a cyclical than a linear process. This study is a first step toward a more systematic evaluation of out-of-home participation among older adults with and without dementia.

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  • 38.
    Margot-Cattin, Isabel
    et al.
    Univ Appl Sci & Arts Western Switzerland HES SO, Sch Social Work & Hlth HETSL, Dept Occupat Therapy, Lausanne, Switzerland; Karolinska Inst, Dept Neurobiol Care Sci & Soc NVS, Div Occupat Therapy, Stockholm, Sweden.
    Ludwig, Catherine
    Univ Appl Sci & Arts Western Switzerland, HES SO, Geneva Sch Hlth Sci, Geneva, Switzerland.
    Kuhne, Nicolas
    Univ Appl Sci & Arts Western Switzerland HES SO, Sch Social Work & Hlth HETSL, Dept Occupat Therapy, Lausanne, Switzerland.
    Eriksson, Gunilla
    Karolinska Inst, Dept Neurobiol Care Sci & Soc NVS, Div Occupat Therapy, Stockholm, Sweden.
    Berchtold, Andre
    Lausanne Univ UNIL, Fac Social & Polit Sci, Lausanne, Switzerland.
    Nygard, Louise
    Karolinska Inst, Dept Neurobiol Care Sci & Soc NVS, Div Occupat Therapy, Stockholm, Sweden.
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Visiting Out-of-Home Places when Living with Dementia2021In: Canadian Journal of Occupational Therapy / Revue Canadienne d`Ergotèrapie, ISSN 0008-4174, Vol. 88, no 2, p. 131-141, article id 00084174211000595Article in journal (Refereed)
    Abstract [en]

    Background. Persons living with dementia face a reduction of their life space outside home and disengagement from participation, linked to places visited. Purpose. This study explored stability and change in perceived participation in places visited outside home and its relationship with occupational gaps among older adults. Method. Older adults living with (n = 35) or without (n = 35) dementia were interviewed using the Participation in ACTivities and Places OUTside Home (ACT-OUT) questionnaire and the Occupational Gaps Questionnaire (OGQ). Data analysis used descriptive and inferential statistics. Findings. The group of people living with dementia reported significantly fewer places (p < .001) visited than the comparison group and having abandoned more places visited (p < .001) than the comparison group. The number of occupational gaps was significantly different between groups (p < .001). Implications. Participation outside home is not influenced in a uniform and straightforward way for persons living with dementia; the shrinking world effect appears differently in relation to types of places.

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  • 39. Mirza, Mansha
    et al.
    Gecht-Silver, Maureen
    Keating, Emily
    Krischer, Amy
    Kim, Hajwa
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Feasibility and Preliminary Efficacy of an Occupational Therapy Intervention for Older Adults With Chronic Conditions in a Primary Care Clinic2020In: American Journal of Occupational Therapy, ISSN 0272-9490, E-ISSN 1943-7676, Vol. 74, no 5, article id 7405205030Article in journal (Refereed)
    Abstract [en]

    Importance: Occupational therapy can play a role in primary care management of chronic diseases among older adults. Objective: To assess the feasibility of delivering a primary care occupation-focused intervention (Integrated PRimary care and Occupational therapy for Aging and Chronic disease Treatment to preserve Independence and Functioning, or i-PROACTIF) for older adults with chronic disease. Design: Feasibility study comparing i-PROACTIF with complex care management using a two-group randomized controlled trial design with data gathered at baseline and during and after the 8-wk intervention. Setting: Family medicine clinic serving an urban, low-income, working-class community. Outcomes and Measures: Feasibility indicators were recruitment, retention, utility of clinical assessments, and acceptability of interventions assessed through feedback surveys completed by patients and primary care providers (PCPs). Patient outcomes, including perspectives on chronic illness care, occupational performance, and overall well-being, were collected using standardized, validated measures and analyzed descriptively. Participants: Eighteen adult volunteers, ages X50 yr, with heart disease, arthritis, and uncontrolled diabetes completed the study. Ten PCPs completed feedback surveys. Intervention: i-PROACTIF focuses on preserving functional independence, is based on the Person-Environment-Occupation framework, and consists of two assessment sessions and six weekly treatment sessions. Results: Recruitment goals were achieved, with an 86% retention rate. Clinical measures unearthed deficits in areas that were unreported or underreported by patients. Participants reported being extremely satisfied with the intervention. Physicians and nurses also supported the intervention. Both groups showed improved scores on most outcomes. Conclusion and Relevance: Delivering and evaluating i-PROACTIF was feasible and acceptable. Future efficacy trials are needed before it can be used in clinical settings. What This Article Adds: The results of this study can inform future occupational therapy interventions and clinical trials in primary care for older adults with chronic conditions.

  • 40.
    Patomella, Ann-Helen
    et al.
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Guidetti, Susanne
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Mälstam, Emelie
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.;Univ Gavle, Fac Hlth & Occupat Studies, Gavle, Sweden..
    Eriksson, Christina
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Bergström, Aileen
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Åkesson, Elisabet
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Asaba, Eric
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Primary prevention of stroke: randomised controlled pilot trial protocol on engaging everyday activities promoting health2019In: BMJ Open, E-ISSN 2044-6055, Vol. 9, no 11, article id e031984Article in journal (Refereed)
    Abstract [en]

    Introduction Stroke is a globally common disease that has detrimental effects on the individual and, more broadly, on society. Lifestyle change can contribute to reducing risk factors for stroke. Although a healthy lifestyle has direct benefits, sustaining and incorporating healthy activities into everyday life is a challenge. Engaging everyday activities have the potential to support lifestyle change and to promote sustainable activity patterns. Current healthcare is failing to reduce modifiable risk factors in people at risk, and in addition to current practice, there is a need for systematic and efficient non-pharmacological and non-surgical stroke-prevention strategies. The aim of the pilot study was to increase knowledge about the effects of a prevention programme and its feasibility to promote sustainable and healthy activity patterns among persons at risk of stroke. Methods and analysis The proposed pilot study will be a two-armed randomised, assessor-blinded, parallel pilot trial. The study will include feasibility data, investigating acceptability and delivery of the intervention. Persons at risk of stroke (n=60) will be included in a mobile phone-supported prevention programme. The 10-week programme will be conducted at primary healthcare clinics, combining group meetings and online resources to support self-management of lifestyle change. Main outcomes are stroke risk, lifestyle habits and healthy activity patterns. Assessments will be performed at baseline and at follow-up (immediately following the end of the programme and at 6 and 12 months). Effects of the programme will be analysed using inferential statistics. Feasibility will be analysed using both qualitative and quantitative methods.

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  • 41. Patomella, Ann-Helen
    et al.
    Mickols, Gustav
    Asaba, Eric
    Nilsson, Gunnar
    Friden, Cecilia
    Bertilson, Bo Christer
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Tham, Kerstin
    Malmö University, Joint University Administration and Services.
    General practitioners' reasoning on risk screening and primary prevention of stroke: a focus group study2018In: BMC Family Practice, E-ISSN 1471-2296, Vol. 19, no 1, article id 190Article in journal (Refereed)
    Abstract [en]

    BackgroundBy screening and modifying risk factors, stroke incidence can be reduced. Clinical guidelines states that primary prevention of stroke is a responsibility and task of primary health care, but research shows that this not always the case. The aim of the study was to explore and describe what characterizes GPs' reasoning around risk screening and primary prevention among persons at risk for stroke in primary health care.MethodsA qualitative design based in a grounded theory approach was chosen in order to investigate this unexplored research area. Data collection was done using focus group interviews and data was analysed using a constant comparative method. Twenty-two GPs were interviewed in four focus groups.ResultsFindings showed that GPs perceived difficulties in prioritizing patients with an unhealthy lifestyle and described a lack of systematicity in their procedures, which complicated their clinical decisions concerning patients with stroke risk factors. The results showed a lack of systematic risk screening methods. Time constraints and the reimbursement system were described as hindering the preventive work.ConclusionThere is a need for a more proactive, transparent and systematic approach in the distribution of GPs' time and reimbursement of prevention in primary health care. The findings suggest, by developing new methods and approaches such as digital clinical decision-making tools and by implementing inter-professional team-work, the quality of the primary prevention of stroke could be improved.

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  • 42.
    Peterson, Elizabeth
    et al.
    Department of Occupational Therapy, University of Illinois Chicago, Chicago, Illinois, USA.
    Keehn, Mary Therese
    Office of the Vice Chancellor for Health Affairs, University of Illinois Chicago, Chicago, Illinois, USA.
    Hasnain, Memoona
    Department of Family and Community Medicine, College of Medicine, University of Illinois Chicago, Chicago, Illinois, USA.
    Gruss, Valerie
    College of Nursing, University of Illinois Chicago, Chicago, Illinois, USA.
    Axelsson, Malin
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Carlson, Elisabeth
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Jakobsson, Jenny
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Exploring differences in and factors influencing self-efficacy for competence in interprofessional collaborative practice among health professions students2024In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 38, no 1, p. 104-112Article in journal (Refereed)
    Abstract [en]

    The value of health care delivered via effective interprofessional teams has created an imperative for interprofessional education (IPE) and interprofessional collaborative practice (ICP). To inform IPE strategies, we investigated differences in perceived self-efficacy (SE) for competence in ICP among health professions students. Study data was collected between 2015-2019 from students from 13 different programs (N=3,496) before an annual institutional interprofessional program. Students completed the IPECC-SET, a validated instrument evaluating perceived SE for competence in ICP, and rated their 1) amount of previous contact with, and 2) perceived understanding of the role of different health professions.  Student groups were compared using parametric statistics. Regression analyses explored factors influencing SE for competence in ICP. Findings revealed significant differences in perceived SE for competence in ICP between programs (p<.05). Specifically, health information management/health informatics, dental, medicine, and nursing students expressed relatively higher SE, whereas physical and occupational therapy students expressed relatively lower SE. Perceived understanding of the role of health care professions (p<.01) and gender (p<.01) contributed significantly to predict perceived SE for competence in ICP, while amount of previous contact with other health professions did not (p=.42).  Findings highlight the value of IPE designed with consideration of specific learner needs.

  • 43.
    Preissner, Katharine
    et al.
    Department of Occupational Therapy, University of Illinois Chicago, Chicago, United States.
    Duke, Kathryn Bernice
    Occupational Therapy Department, West Coast University, Los Angeles, CA, United States.
    Killian, Catherine
    Occupational Therapy Program, Midwestern University, Downers Grove, IL, United States.
    Ouyang, Rachel Luangdilok
    Fox Rehabilitation, Westmont, IL, United States.
    Jarek, Eva D
    Community Physical Therapy, Chicago, United States.
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    The Revised American Occupational Therapy Association Fieldwork Performance Evaluations: Evaluation of Content Validity-Part 12020In: American Journal of Occupational Therapy, ISSN 0272-9490, E-ISSN 1943-7676, Vol. 74, no 6, article id 7406205090Article in journal (Refereed)
    Abstract [en]

    IMPORTANCE: Occupational therapy education and practice has changed over time; however, items on the American Occupational Therapy Association's (AOTA's) Fieldwork Performance Evaluations (FWPEs) for the Occupational Therapy Student (OTS) and Occupational Therapy Assistant Student (OTAS) have not been updated in more than two decades.

    OBJECTIVE: To explore evidence of validity in relation to test content of the revised FWPEs for the OTS and OTAS.

    DESIGN: A qualitative study using cognitive interviews was conducted to gather perspectives on the revised FWPEs, including updated items and a proposed rating scale. A content analysis approach was used to link patterns in responses to stable, meaningful constructs to further align and refine content of the tool before further validation.

    SETTING: Fieldwork sites and academic settings.

    PARTICIPANTS: Eighteen fieldwork educators (FWEs) and academic fieldwork coordinators.

    RESULTS: Seven areas for refinement were identified: (1) relevance to a variety of practice settings, (2) overlapping and redundant items, (3) long item statements, (4) double- and triple-barreled item statements, (5) alignment between OTS and OTAS items, (6) further alignment with AOTA and Accreditation Council for Occupational Therapy Education documents and contemporary practice, and (7) wording and features of the proposed rating scale. The findings guided revisions of FWPE content.

    CONCLUSIONS AND RELEVANCE: Cognitive interviewing was a critical step in refining the FWPE items to support content validity. The issues identified may not have been detected using traditional approaches to survey development and therefore were critical in maximizing the validity and usefulness of the final items, which will ultimately benefit fieldwork educators and students.

    WHAT THIS ARTICLE ADDS: This study resulted in refinements to FWPE items before the next step in the validation process, ultimately improving the final FWPE items. In addition, this article outlines a process that other researchers can use to validate similar tools.

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  • 44.
    Ramji, Rathi
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Carlson, Elisabeth
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Brogårdh-Roth, Susanne
    Malmö University, Faculty of Odontology (OD).
    Olofsson, Anna Nilvéus
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Rämgård, Margareta
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Understanding behavioural changes through community-based participatory research to promote oral health in socially disadvantaged neighbourhoods in Southern Sweden.2020In: BMJ Open, E-ISSN 2044-6055, Vol. 10, no 4, article id e035732Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Inequalities in oral health have been on the rise globally. In Sweden, these differences exist not between regions, but among subgroups living in vulnerable situations. This study aims at understanding behavioural change after taking part in participatory oral health promotional activity among families living in socially disadvantaged neighbourhoods in Southern Sweden.

    SETTING: The current study involved citizens from a socially disadvantaged neighbourhood in Malmö, together with actors from the academic, public and private sectors. These neighbourhoods were characterised by high rates of unemployment, crime, low education levels and, most importantly, poor health.

    PARTICIPANTS: Families with children aged 7-14 years from the neighbourhood were invited to participate in the health promotional activities by a community representative, known as a health promoter, using snowball sampling. Between 8 and 12 families participated in the multistage focus groups over 6 months. Data were analysed using qualitative content analysis.

    RESULTS: Three main themes emerged from the analysis, providing an understanding of the determinants for behavioural change, including meaningful social interactions, family dynamics and health trajectories. The mothers in the study valued the social aspects of their participation; however, they believed that gaining knowledge in combination with social interaction made their presence also meaningful. Further, the participants recognised the role of family dynamics primarily the interactions within the family, family structure and traditional practices as influencing oral health-related behaviour among children. Participants reported having experienced a change in general health owing to changed behaviour. They started to understand the association between general health and oral health that further motivated them to follow healthier behavioural routines.

    CONCLUSIONS: The results from this study show that oral health promotion through reflection and dialogue with the communities, together with other stakeholders, may have the potential to influence behavioural change and empower participants to be future ambassadors for change.

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  • 45.
    Ramji, Rathi
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Carlson, Elisabeth
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Rämgård, Margareta
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Impact of a CBPR-informed physical activity intervention before and during COVID-19 among women from a disadvantaged neighborhood in Sweden.2022In: Frontiers In Public Health, ISSN 2296-2565, Vol. 10, article id 997329Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Public health practitioners have been striving to reduce the social gradient and promote physical activity among citizens living in disadvantaged neighborhoods. The emergence of the COVID-19 pandemic, which has affected these citizens extensively, has posed a significant challenge to efforts to maintain a physically active lifestyle. Thus, the aim of this study was to explore the impact of a CBPR-informed physical activity intervention before and during the COVID-19 pandemic from the perspective of women from a socially disadvantaged neighborhood.

    METHODS: A total of 34 women participated in a CBPR-informed physical activity intervention previously developed in collaboration with lay health promoters and other citizens from the same neighborhood. Focus group discussions were conducted at four time points, namely, at baseline prior to the intervention, post-intervention, 6 months after the intervention ended, and during the COVID-19 pandemic. The data were analyzed using qualitative content analysis following an inductive approach.

    RESULTS: In total, four themes emerged from the discussions: "Wavering between frustration and action," "Shifting from prioritizing family needs to taking control of self," "Between isolation and social support," and "Restricted access to health-related knowledge vs. utilizing internalized knowledge".

    CONCLUSION: The results of this study reveal that building on CBPR-informed health promotion initiatives has the potential to foster individual empowerment and assist during acute situations like the COVID-19 pandemic through mobilizing communities and their resources, which leads to increased community resilience and health. This study is regarded as unique in that it involves evaluation of a CBPR intervention that was initiated ahead of the pandemic and followed even during the pandemic.

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  • 46.
    Ramji, Rathi
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Carlson, Elisabeth
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Shleev, Sergey
    Malmö University, Faculty of Health and Society (HS), Department of Biomedical Science (BMV). Malmö University, Biofilms Research Center for Biointerfaces.
    Awad, Eman
    Malmö University, Faculty of Health and Society (HS), Department of Biomedical Science (BMV).
    Rämgård, Margareta
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Development and evaluation of a physical activity intervention informed by participatory research: a feasibility study2020In: BMC Public Health, E-ISSN 1471-2458, Vol. 20, article id 112Article in journal (Refereed)
    Abstract [en]

    Background: Despite numerous interventions aiming to improve physical activity in socially disadvantagedpopulations, physical inactivity remains to be a rising challenge to public health globally, as well as, in Sweden. Inan effort to address this challenge, a community-based participatory intervention was developed through activecommunity engagement and implemented in a socially disadvantaged neighborhood in Sweden. The current studyaims to present the development and initial evaluation of a participatory research driven physical activityintervention.Methods: Fifteen participants (11 females and 4 males) aged 17–59 years volunteered to participate in the physicalactivity intervention program. The intervention program was evaluated using a longitudinal mixed methods designmeasuring health impact changes over time through focus group discussions and quality of life surveys. Furtheradditional biomedical health parameters such as levels of glycosylated hemoglobin, blood pressure, levels ofoxygen saturation and body mass index were monitored before and after the intervention. Focus group data wereanalyzed using content analysis with an inductive approach. The pre-and post-test scores from the survey-basedquality of life domains, as well as the health parameters were compared using non-parametric and parametricstatistics.Results: Four themes emerged from the analysis of the focus group discussions including sense of fellowship,striving for inclusion and equity, changing the learner perspective and health beyond illness. The scores for thedomains Physical Health, Psychological Health, Social Relationships and Health Satisfaction where significantlyhigher after participation in the physical activity intervention program compared to the pre-test scores (p < .05)s.There were however, no significant changes in the scores for the environmental domain and overall quality of lifeafter intervention compared to that prior to intervention start. Overall, the biomedical health parameters remainedstable within the normal ranges during intervention.Conclusion: The focus group discussions and results from the surveys and biomedical measures reveal importantfindings to understand and further develop the intervention program to promote health equity among citizens indisadvantaged areas. Evaluating the feasibility of such an intervention using multiple approaches contributes toeffective implementation of it for larger communities in need.

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  • 47.
    Ramji, Rathi
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Rämgård, Margareta
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Carlson, Elisabeth
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Shleev, Sergey
    Malmö University, Faculty of Health and Society (HS), Department of Biomedical Science (BMV).
    Awad, Eman
    Malmö University, Faculty of Health and Society (HS), Department of Biomedical Science (BMV).
    Cirovic, Stefan
    Malmö University, Faculty of Health and Society (HS), Department of Biomedical Science (BMV).
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Health and quality of life among women after participation in a CBPR-informed physical activity intervention: with a pandemic perspective.2023In: Scientific Reports, E-ISSN 2045-2322, Vol. 13, no 1, article id 17972Article in journal (Refereed)
    Abstract [en]

    The lack of culturally and contextually oriented interventions promoting physical activity (PA) has led to increased physical inactivity among women living in disadvantaged neighbourhoods in Sweden. In this study one such intervention informed by community-based participatory research (CBPR) has been evaluated among 34 women from a disadvantaged neighbourhood before and during COVID-19. Health-related quality of life (HRQOL), behavioural and biomedical outcomes were assessed directly prior and post-intervention, followed by evaluations at 6-months and 18-months follow-up during COVID-19. The results revealed that HRQOL, particularly psychological, social, and environmental health significantly increased post-intervention compared to prior to intervention but reversed back at 6-months follow-up. Perceived health satisfaction and environmental health increased at 18-months follow-up during COVID-19. Participation in PA improved post-intervention and at 6-months follow-up. Everyday activities and fruit and vegetable intake continued to increase through all timepoints. Systolic blood pressure significantly decreased post-intervention and 6-months follow-up; blood flow rate increased significantly at all timepoints. Overall, the findings underscores the potential effectiveness of CBPR approaches in promoting and sustaining healthy lifestyles, even during acute situations such as the COVID-19. It may even serve as a future model for promoting health and addressing health disparities in similar groups.

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  • 48.
    Ramji, Rathi
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Rämgård, Margareta
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Psychometric properties of the WHOQOL-BREF in citizens from a disadvantaged neighborhood in Southern Sweden2023In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 14Article in journal (Refereed)
    Abstract [en]

    Background: Citizens living in disadvantaged neighborhoods experience poorer health than the majority, and this inequality is a public health problem even in a welfare state such as Sweden. Numerous initiatives aimed at improving health and quality of life in these populations are being implemented and evaluated. Given that these populations are predominantly multicultural and multilingual, an instrument such as the WHOQOL-BREF, which is cross-culturally validated and available in multiple languages, may be appropriate. However, this cannot be ascertained since the psychometric properties of WHOQOL-BREF have never been assessed in the Swedish context. Thus, the current study aimed at assessing the psychometric properties of the WHOQOL-BREF questionnaire in citizens from a disadvantaged neighborhood in Southern Sweden.

    Methods: The respondents in this study were 103 citizens who participated in the health promotional activities of a Health promotional program and also responded to the 26-item, WHOQOL-BREF questionnaire as a part of an evaluation to assess the impact of the activities on the health-related quality of life of citizens. A Rasch model using WINSTEP 4.5.1 was used to assess the psychometric properties in this study.

    Results: Five of the 26 items, including pain and discomfort, dependence on medical substances, physical environment, social support, and negative feelings did not display acceptable goodness-of-fit to the Rasch model. On removing these items, the 21-item WHOQOL-BREF scale had an improved internal scale validity and person-separation reliability than the original 26-item version for this group of citizens from the neighborhood. When assessing the individual domains, three of the five items that were misfits on analyzing the full model also showed misfits in relation to two respective domains. When these items were removed, the internal scale validity of the domains also improved.

    Conclusion: WHOQOL-BREF seemed to be psychometrically inadequate when used in the original form due to internal scale validity problems, while the modified 21-item scale seemed better at measuring the health-related quality of life of citizens living in socially disadvantaged neighborhoods in Sweden. Omission of items shall be done but with caution. Alternatively, future studies may also consider rephrasing the items with misfits and further testing the instrument with larger samples exploring the associations between subsamples and specific item misfit responses.

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  • 49. Rozental, Alexander
    et al.
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Forsström, David
    Månsson, Kristoffer
    Boettcher, Johanna
    Andersson, Gerhard
    Furmark, Tomas
    Carlbring, Per
    The Negative Effects Questionnaire: psychometric properties of an instrument for assessing negative effects in psychological treatments2019In: Behavioural and Cognitive Psychotherapy, ISSN 1352-4658, E-ISSN 1469-1833, Vol. 47, no 5, p. 559-572Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Psychological treatments provide many benefits for patients with psychiatric disorders, but research also suggests that negative effects might occur from the interventions involved. The Negative Effects Questionnaire (NEQ) has previously been developed as a way of determining the occurrence and characteristics of such incidents, consisting of 32 items and six factors. However, the NEQ has yet to be examined using modern test theory, which could help to improve the understanding of how well the instrument works psychometrically. AIMS: The current study investigated the reliability and validity of the NEQ from both a person and item perspective, establishing goodness-of-fit, item bias, and scale precision. METHOD: The NEQ was distributed to 564 patients in five clinical trials at post-treatment. Data were analysed using Rasch analysis, i.e. a modern test theory application. RESULTS: (1) the NEQ exhibits fairness in testing across sociodemographics, (2) shows comparable validity for a final and condensed scale of 20 instead of 32 items, (3) uses a rating scale that advances monotonically in steps of 0 to 4, and (4) is suitable for monitoring negative effects on an item-level. CONCLUSIONS: The NEQ is proposed as a useful instrument for investigating negative effects in psychological treatments, and its newer shorter format could facilitate its use in clinical and research settings. However, further research is needed to explore the relationship between negative effects and treatment outcome, as well as to test it in more diverse patient populations.

  • 50. Rustøen, Tone
    et al.
    Lerdal, Anners
    Gay, Caryl
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Rasch analysis of the Herth Hope Index in cancer patients2018In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 16Article in journal (Refereed)
    Abstract [en]

    Background: The concept of hope has been measured using the Herth Hope Index (HHI) in different samples, but varying factor structures comprising different items from the HHI have been reported. Therefore, further testing with regard to the dimensionality of the instrument is recommended. Rasch modeling can be used to evaluate validity evidence of an instrument's underlying structure, to identify items with poor fit to the rest of the scale, and to identify items that perform inconsistently across groups. The aim of this study was to assess the HHI's psychometric properties in a sample of cancer patients using a Rasch model. Adult oncology outpatients (n = 167) with pain from bone metastasis were included, and medical records were reviewed for disease and treatment information. Patients completed the 12-item HHI, which measures various dimensions of hope using a 4-point Likert scale that ranges from 1 (strongly disagree) to 4 (strongly agree). The internal scale validity, person response validity, unidimensionality, and uniform differential item functioning were evaluated by applying a Rasch rating scale model. Results: Five (42%) of the twelve items (#3, #4, #5, #6 and #7) did not meet the criterion set for item goodness-of-fit. After removing these 5 items, the resulting 7-item scale demonstrated acceptable item fit to the model, acceptable unidimensionality (52.6% of the variance explained), acceptable person goodness-of-fit adequate separation, and no differential item function. Conclusion: A 7-item version of the HHI had better psychometric properties than the original 12-item version among patients with cancer-related pain.

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