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  • 1.
    Afroz, B.
    et al.
    Karlstad University, Division of Public Health Sciences.
    Moniruzzaman, S.
    Karlstad University, Division of Public Health Sciences.
    Stark Ekman, Diana
    University West, Department of Nursing, Health and Culture, Division of Health and Culture.
    Andersson, R.
    Karlstad University, Division of Public Health Sciences.
    The impact of economic crisis on injury mortality: The case of the 'Asian crisis'2012In: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 126, no 10, p. 836-838Article in journal (Refereed)
  • 2.
    Bendtsen, Preben
    et al.
    Linköping University, Department of Medical and Health Science, Division of Community Medicine.
    Stark Ekman, Diana
    University West, Department of Nursing, Health and Culture, Division of Health and Culture.
    Johansson, AnneLie
    Linköping University, Department of Medical and Health Science, Division of Community Medicine.
    Carlfjord, Siw
    Linköping University, Department of Medical and Health Science, Division of Community Medicine.
    Andersson, Agneta
    Linköping University, Department of Medical and Health Science, Division of Community Medicine.
    Leijon, Matti
    Linköping University, Department of Medical and Health Science, Division of Community Medicine.
    Johansson, Kjell
    Linköping University, Department of Medical and Health Science, Division of Community Medicine.
    Nilsen, Per
    Linköping University, Department of Medical and Health Science, Division of Community Medicine.
    Referral to an electronic screening and brief alcohol intervention in primary health care in Sweden: Impact of staff referral to the computer2011In: International Journal of Telemedicine and Applications, ISSN 1687-6415, E-ISSN 1687-6423, ISSN 1687-6415, Vol. 918763Article in journal (Refereed)
    Abstract [en]

    The aim of this paper was to evaluate whether primary health care staff's referral of patients to perform an electronic screening and brief intervention (e-SBI) for alcohol use had a greater impact on change in alcohol consumption after 3 month, compared to patients who performed the test on their own initiative. Staff-referred responders reported reduced weekly alcohol consumption with an average decrease of 8.4 grams. In contrast, self-referred responders reported an average increase in weekly alcohol consumption of 2.4 grams. Staff-referred responders reported a 49 reduction of average number of heavy episodic drinking (HED) occasions per month. The corresponding reduction for self-referred responders was 62. The differences between staff- and self-referred patient groups in the number who moved from risky drinking to nonrisky drinking at the followup were not statistically significant. Our results indicate that standalone computers with touchscreens that provide e-SBIs for risky drinking have the same effect on drinking behaviour in both staff-referred patients and self-referred patients. Copyright © 2011 Preben Bendtsen et al.

  • 3.
    Ekman, Diana Stark
    et al.
    University West, Department of Nursing, Health and Culture, Division of Health and Culture.
    Ekman, Robert
    Karlstad University, Department of Health and Environmental Sciences.
    Twenty-five years of bicycle helmet promotion for children in Skaraborg District, Sweden.2012In: International Journal of Injury Control and Safety Promotion, ISSN 1745-7300, E-ISSN 1745-7319, Vol. 19, no 3, p. 213-217Article in journal (Refereed)
    Abstract [en]

    The purpose of this study is to describe some of the results of a long-term bicycle helmet campaign for children in Skaraborg District, Sweden. The hospital discharge data for bicycle-related injuries occurring in children under the age of 15 were reviewed, to assess changes in patterns for head and other body injuries. The study shows that head injuries to children as a result of bicycle injuries were reduced between 94 and 99% in the study areas. The tremendous gains in safety for children who ride bicycles in Skaraborg District were the result of not only national policy changes that occurred in the latter half of this study period but also the result of local collaborations based on the Safe Communities model, which were organised during the first part of the study period.

  • 4.
    Leijon, Matti
    et al.
    Lund University/Region Skåne, Center for Primary Health Care Research.
    Arvidsson, Daniel
    Lund University/Region Skåne, Center for Primary Health Care Research.
    Nilsen, Per
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine.
    Stark Ekman, Diana
    University West, Department of Nursing, Health and Culture, Division of Health and Culture.
    Carlfjord, Siw
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine.
    Andersson, Agneta
    Linköping University, County Council of Östergötland, R&D Department of Local Health Care.
    Johansson, Anne Lie
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine.
    Bendtsen, Preben
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine.
    Improvement of physical activity by a kiosk-based electronic screening and brief intervention in routine primary health care: Patient-initiated versus staff-referred2011In: Journal of Medical Internet Research, Vol. 13, no 4, p. e99-Article in journal (Refereed)
    Abstract [en]

    Background: Interactive behavior change technology (eg, computer programs, Internet websites, and mobile phones) may facilitate the implementation of lifestyle behavior interventions in routine primary health care. Effective, fully automated solutions not involving primary health care staff may offer low-cost support for behavior change. Objectives: We explored the effectiveness of an electronic screening and brief intervention (e-SBI) deployed through a stand-alone information kiosk for promoting physical activity among sedentary patients in routine primary health care. We further tested whether its effectiveness differed between patients performing the e-SBI on their own initiative and those referred to it by primary health care staff. Methods: The e-SBI screens for the physical activity level, motivation to change, attitudes toward performing the test, and physical characteristics and provides tailored feedback supporting behavior change. A total of 7863 patients performed the e-SBI from 2007 through 2009 in routine primary health care in Östergötland County, Sweden. Of these, 2509 were considered not sufficiently physically active, and 311 of these 2509 patients agreed to participate in an optional 3-month follow-up. These 311 patients were included in the analysis and were further divided into two groups based on whether the e-SBI was performed on the patient's own initiative (informed by posters in the waiting room) or if the patient was referred to it by staff. A physical activity score representing the number of days being physically active was compared between baseline e-SBI and the 3-month follow-up. Based on physical activity recommendations, a score of 5 was considered the cutoff for being sufficiently physically active. Results: In all, 137 of 311 patients (44%) were sufficiently physically active at the 3-month follow-up. The proportion becoming sufficiently physically active was 16/55 (29%), 40/101 (40%), and 81/155 (52%) for patients with a physical activity score at baseline of 0, 1 to 2, and 3 to 4, respectively. The patient-initiated group and staff-referred group had similar mean physical activity scores at baseline (2.1, 95% confidence interval [CI] 1.8-2.3, versus 2.3, 95% CI 2.1-2.5) and at follow-up, (4.1, 95% CI 3.4-4.7, vs 4.2, 95% CI 3.7-4.8). Conclusions: Among the sedentary patients in primary health care who participated in the follow-up, the e-SBI appeared effective at promoting short-term improvement of physical activity for about half of them. The results were similar when the e-SBI was patient-initiated or staff-referred. The e-SBI may be a low-cost complement to lifestyle behavior interventions in routine primary health care and could work as a stand-alone technique not requiring the involvment of primary health care staff. © Matti Leijon, Daniel Arvidsson, Per Nilsen, Diana Stark Ekman, Siw Carlfjord, Agneta Andersson, Anne Lie Johansson, Preben Bendtsen.

  • 5.
    Nyberg, Cecilia
    et al.
    Karlstad Univ, Dept Publ Hlth.
    Schyllander, Jan
    Karlstad Univ, Dept Publ Hlth.
    Ekman, Diana Stark
    University West, Department of Nursing, Health and Culture, Division of Health and Culture.
    Janson, Staffan
    Karlstad Univ, Dept Publ Hlth.
    Socio-economic risk factors for injuries in Swedish children and adolescents: A national study over 15 years2012In: Global Public Health, ISSN 1744-1692, E-ISSN 1744-1706, Vol. 7, no 10, p. 1170-1184Article in journal (Refereed)
    Abstract [en]

    Few studies have assessed if Sweden's injury prevention work has been equally effective for children of different socio-economic backgrounds. The goal of this paper is to review the country's injury rates for children over time, stratified by socio-economic status (SES), to see if the effects are similar across SES levels. This study employs a retrospective case-control study design, using data from the hospitalisation records of 51,225 children, which were linked to family socio-economic data. Children and adolescents in families receiving social welfare benefits, and those living with single parents and mothers with less education had higher risks of injuries leading to hospitalisation. The population-based safety work over the past decades seems to have had only minor effects on reducing the impact of socio-economic based difference in injury risks to younger Swedes.

  • 6.
    Schyllander, Jan
    et al.
    Swedish Civil Contingencies Agcy, Karlstad.
    Janson, Staffan
    Karlstad Univ, Div Publ Hlth Sci.
    Nyberg, Cecilia
    Karlstad Univ, Div Publ Hlth Sci.
    Eriksson, Ulla-Britt
    Karlstad Univ, Div Publ Hlth Sci.
    Ekman, Diana Stark
    University West, Department of Nursing, Health and Culture, Division of Health and Culture.
    Case analyses of all children's drowning deaths occurring in Sweden 1998-20072013In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 41, no 2, p. 174-179Article in journal (Refereed)
    Abstract [en]

    Aims: The goal of this research project was to explore circumstances surrounding each drowning death occurring to children and adolescents ages 0-17 in Sweden during the years 1998-2007. Methods: Records from the National Board of Forensic Medicine (NBFM) and other sources were analysed. We collected information on children's personal characteristics (sex, age, ethnic background, weight, height, physical condition, and pre-existing health conditions) and the circumstances of deaths (time and place of occurrence, type of drowning, resuscitation efforts and medical care given, for example). We also collected information on prevention factors: the physical environment, adult supervision, whether or not the child could swim, and if the child was using a personal flotation device at the time of death. Results: Our analysis showed that 109 children had drowned in Sweden during the study period - of this group, 96 had died from unintentional causes. Children from immigrant backgrounds, particularly with families coming from the Middle East and Iran, were inordinately represented in the group of victims who had died from unintentional drowning deaths. Other risk factors included: coming from a single parent-headed family, alcohol use by older victims and a lack of ability to swim. Conclusions: Prevention efforts to prevent drowning in the future should focus on preventing alcohol use by young bathers; better fencing around swimming sites; improved coverage of swimming lessons to all children in Sweden, especially children from immigrant families; more education on drowning risks for single parents; and better awareness by adults on the need for constant supervision of children and adolescents in and near water.

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