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Fysisk aktivitet på recept i en svensk skolkontext – medikalisering eller dörröppnare för rörelse
Malmö University, Faculty of Education and Society (LS), Department of Sports Sciences (IDV).ORCID iD: 0000-0002-0770-4313
2025 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [sv]

Denna avhandling i idrottsvetenskap utforskar hur fysisk aktivitet på recept (FaR) används som hälsofrämjande metod för barn i skolmiljö – en kontext där metoden hittills studerats i begränsad utsträckning. Mot bakgrund av att många barn rör sig för lite och inte når rekommenderade nivåer av fysisk aktivitet, har skolan pekats ut som en viktig arena för hälsofrämjande insatser. Samtidigt är det oklart hur en medicinsk metod som FaR fungerar i skolans pedagogiska vardag. 

Med hjälp av kvalitativa metoder och utifrån barns, vårdnadshavares och skolpersonals perspektiv studeras hur FaR förstås, organiseras och tas emot i skolans komplexa miljö. 

Resultaten visar att FaR kan fungera som en dörröppnare till fysisk aktivitet, särskilt för barn som annars riskerar att hamna utanför rörelseaktiviteter. Samtidigt framträder spänningsfält mellan medicinska och pedagogiska logiker, mellan individanpassning och ansvarsförskjutning samt mellan stöd och risk för stigmatisering. För barnen är det inte receptet i sig som är avgörande, utan aktivitetens innehåll, relationer och känslan av sammanhang. 

Avhandlingen bidrar med ny kunskap om hur skolbaserade hälsoinsatser kan utformas mer jämlikt, barncentrerat och långsiktigt hållbart. Genom att förena medicinska, sociologiska och pedagogiska perspektiv lyfts behovet av att utveckla mer rättighetsbaserade och barnsensitiva former av hälsofrämjande arbete.

Abstract [en]

This dissertation in sports science explores how Physical Activity on Prescription (PAP) is used as a health-promoting method for children in the school setting – a context in which the method has so far been studied to a limited extent. Given that many children are insufficiently physically active and do not meet the recommended levels of physical activity, schools have been identified as an important arena for health-promoting interventions. At the same time, it remains unclear how a medical method like PAP functions within the pedagogical everyday life of schools.

Using qualitative methods and drawing on the perspectives of children, guardians, and school staff, the study examines how PAP is understood, organized, and received in the complex school environment.

The results show that PAP can function as a door-opener to physical activity, particularly for children who might otherwise be excluded from organised physical activity. At the same time, tensions emerge between medical and pedagogical logics, between individual adaptation and shifting of responsibility, and between support and the risk of stigmatization. For children, it is not the prescription itself that is decisive, but the content of the activity, the relationships and the sense of context.

The thesis contributes new knowledge about how school-based health interventions can be designed to be more equitable, child-centered, and sustainable in the long term. By integrating medical, sociological, and pedagogical perspectives, the study highlights the need to develop more rights-based and child-sensitive approaches to health promotion.

Place, publisher, year, edition, pages
Malmö: Malmö University Press, 2025. , p. 155
Series
Malmö Studies in Sport Sciences, ISSN 1652-3180 ; 52
Keywords [en]
physical activity on prescription, children, health promotion, school
Keywords [sv]
fysisk aktivitet på recept, hälsofrämjande arbete, skolan, barns hälsa
National Category
Sport and Fitness Sciences
Identifiers
URN: urn:nbn:se:mau:diva-79062DOI: 10.24834/isbn.9789178776528ISBN: 978-91-7877-651-1 (print)ISBN: 978-91-7877-652-8 (electronic)OAI: oai:DiVA.org:mau-79062DiVA, id: diva2:1992387
Public defence
2025-09-19, OR: D138, Nordenskiöldsgatan 10, 13:15 (Swedish)
Opponent
Supervisors
Note

With a summary in english. 

Paper 4 in dissertation as manuscript. 

Available from: 2025-08-27 Created: 2025-08-27 Last updated: 2025-09-11Bibliographically approved
List of papers
1. "A constant battle against sedentary lifestyle and screen time": Swedish school nurses' views on school children's physical activity and its promotion - a grounded theory study
Open this publication in new window or tab >>"A constant battle against sedentary lifestyle and screen time": Swedish school nurses' views on school children's physical activity and its promotion - a grounded theory study
2024 (English)In: Frontiers in Sports and Active Living, E-ISSN 2624-9367, Vol. 6, article id 1393336Article in journal (Refereed) Published
Abstract [en]

School nurses are in a key position to promote children's physical activity. They engage all children in health dialogues and use different approaches to inform children about physical activity and motivate them to change their physical activity level. In a school context, it is important to explore and problematize school nurses' views of children's physical activity and the influence of these views on their professional practice in the school health service. Identifying and problematizing school nurses' views of physical activity would enable them to create improved guidelines and equivalent ways of working in the future. Therefore, this study aims to discursively explore Swedish school nurses' views on school children's physical activity and its promotion and elucidate them through a discursive framework based on sensitizing concepts. This study uses a qualitative research design with a constructivist grounded theory approach. Semi-structured interviews were conducted with 24 school nurses. The analysis resulted in a core category describing how school nurses use intertwined views to lead children from sedentarity to physical activity. Furthermore, the school nurses' practices were identified in three categories: fostering everyday movement as a tool for health, battling children's sedentarity under difficult conditions, and promoting everyday movement and compensating for unequal access. The results indicate that school nurses lack common and clear guidelines for their mission to promote physical activity to children, which may lead to inequality in access to physical activity for children and young people.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2024
Keywords
children, health promotion, physical activity, school, school nurses, sedentary behavior
National Category
Nursing
Identifiers
urn:nbn:se:mau:diva-70069 (URN)10.3389/fspor.2024.1393336 (DOI)001279077500001 ()39081836 (PubMedID)2-s2.0-85199980654 (Scopus ID)
Available from: 2024-08-02 Created: 2024-08-02 Last updated: 2025-08-27Bibliographically approved
2. Physical Activity on Prescription "Not a Quick Fix": School Nurses' Experiences of Promoting and Tailoring Physical Activity to Children in Swedish Compulsory School
Open this publication in new window or tab >>Physical Activity on Prescription "Not a Quick Fix": School Nurses' Experiences of Promoting and Tailoring Physical Activity to Children in Swedish Compulsory School
2025 (English)In: Journal of School Nursing, ISSN 1059-8405, E-ISSN 1546-8364, Vol. 41, no 3, p. 316-324Article in journal (Refereed) Published
Abstract [en]

This study aimed to explore school nurses' experience of using physical activity on prescription with children in Swedish compulsory school. Semistructured interviews were conducted with 24 school nurses who had the educational qualification to prescribe physical activity. The analysis resulted in one overarching theme, "A delicate process of tailoring physical activity on prescription to a child's social context," and two categories: "Promoting joyful physical activity through individualization and support" and "Dealing with dilemmas and challenges," with related subcategories. The results demonstrate the importance of tailoring prescribed physical activity to each individual child, their living conditions, and the school context. In addition, they highlight the nurses' working conditions and collaborations as important prerequisites when initiating physical activity on prescription. In conclusion, the results suggest that school nurses perceive physical activity on prescription as a useful tool in the school context, but it needs to be tailored to each individual child.

Place, publisher, year, edition, pages
Sage Publications, 2025
Keywords
physical activity, physical activity on prescription, qualitative interviews, school nurses
National Category
Nursing
Identifiers
urn:nbn:se:mau:diva-59225 (URN)10.1177/10598405231166124 (DOI)000954645400001 ()36974431 (PubMedID)2-s2.0-85152052018 (Scopus ID)
Available from: 2023-04-17 Created: 2023-04-17 Last updated: 2025-08-27Bibliographically approved
3. Facilitators and barriers in interprofessional collaboration around physical activity on prescription-a focus group study in a Swedish school setting.
Open this publication in new window or tab >>Facilitators and barriers in interprofessional collaboration around physical activity on prescription-a focus group study in a Swedish school setting.
2024 (English)In: Frontiers in Sports and Active Living, E-ISSN 2624-9367, Vol. 6, article id 1431786Article in journal (Refereed) Published
Abstract [en]

In Swedish school health services, local initiatives have been taken to use physical activity on prescription (PAP) to encourage physically inactive children to become more active. Previous research shows that interprofessional collaboration plays a crucial role in promoting physical activity in children, as well as in promoting health in schools. However, there is a lack of knowledge about PAP for children in the school setting, including how medical and educational staff can work together to encourage children who have been recommended PAP. Therefore, this study aims to explore the perceived facilitators and barriers concerning interprofessional collaboration regarding physical activity on prescription in the school setting, as viewed from the professionals' perspectives. Semi-structured interviews were conducted with 21 professionals who work with the method in school settings. The data were analyzed using Reflexive Thematic Analysis. The results reveal both barriers and facilitators for interprofessional collaboration on PAP in the school setting, as perceived by professionals. Organizational and structural obstacles within school institutions hinder collaboration, while a shared commitment to PAP, characterized by consensus-building, acts as a facilitating factor. PAP for children in a school setting is still an unexplored area and further research is required.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2024
Keywords
children, health promotion, interprofessional collaboration, physical activity, school, school health service
National Category
Public Health, Global Health and Social Medicine
Identifiers
urn:nbn:se:mau:diva-70073 (URN)10.3389/fspor.2024.1431786 (DOI)001280034900001 ()39086852 (PubMedID)2-s2.0-85200051815 (Scopus ID)
Available from: 2024-08-02 Created: 2024-08-02 Last updated: 2025-08-27Bibliographically approved
4. A door opener to physical capability and social community: Children's and parents' experiences of Physical Activity on Prescription by the Swedish School Health Service
Open this publication in new window or tab >>A door opener to physical capability and social community: Children's and parents' experiences of Physical Activity on Prescription by the Swedish School Health Service
(English)Manuscript (preprint) (Other academic)
National Category
Sport and Fitness Sciences
Identifiers
urn:nbn:se:mau:diva-79064 (URN)
Available from: 2025-08-27 Created: 2025-08-27 Last updated: 2025-08-27Bibliographically approved

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