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  • 1.
    Al Adhami, Maissa
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP. Research and Learning for Sustainable Development and Global Health (SWEDESD), Department of Women’s and Children’s Health, Uppsala University , Hammarskjölds väg 14B, 752 37 Uppsala , Sweden.
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Daryani, Achraf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Wångdahl, Josefin
    Aging Research Center, Karolinska Institutet and Stockholm University , Tomtebodavägen 18 A, 171 65 Stockholm , Sweden.
    Larsson, Elin C.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, SWEDESD - Sustainability Learning and Research Centre. Department of Women’s and Children’s Health, Karolinska Institutet , Tomtebodavägen 18A, 171 77 Stockholm , Sweden;Department of Global Public Health, Karolinska Institutet , Tomtebodavägen 18 A, 171 65 Stockholm , Sweden.
    Salari, Raziye
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Can extended health communication improve newly settled refugees’ health literacy? A quasi-experimental study from Sweden2024In: Health Promotion International, ISSN 0957-4824, E-ISSN 1460-2245, Vol. 39, no 2Article in journal (Refereed)
    Abstract [en]

    Structural and contextual factors such as limited work and housing opportunities negatively affect the health and well-being of newly settled refugee migrants in receiving high-income countries. Health promotion initiatives aiming at strengthening health and integration have been tried out within the Swedish Introduction program for refugee migrants. However, longitudinal evaluations of these interventions are rare. The aim of the current study was to compare the effectiveness of a regular and an extended civic orientation course with added health communication and examine whether the latter would improve self-rated health and psychological well-being, health literacy and social capital among newly settled refugee migrants in Sweden. Pre- and post-assessment questionnaires were collected from the intervention group receiving the extended course (n = 143) and a control group receiving the regular course (n = 173). Linear mixed models and chi-square analyses showed a significant increase with a small effect size (0.21) in health literacy in the intervention group. However, there were no significant changes in emotional and practical support, general self-rated health or psychological well-being. The findings indicate that added health communication provided embedded in the civic orientation course can increase health literacy. However, further longitudinal studies are needed to confirm the sustainability of the observed effect and examine whether these short-term improvements in health literacy translate to long-term advances in health and integration.

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  • 2.
    Durbeej, Natalie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Abrahamsson, Ninnie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Papadopoulos, Fotios
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Psychiatry.
    Beijer, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Salari, Raziye
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Outside the norm: Mental health, school adjustment and community engagement in non-binary youth2019In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 49, no 5, p. 529-538Article in journal (Refereed)
    Abstract [en]

    Aims: The aim of this study was to explore the role of self-reported non-binary gender identity in mental health problems, school adjustment, and wish to exert influence on municipal issues in a community sample of adolescents.

    Methods: In a cross-sectional design, data were collected through an anonymous survey in Uppsala County, Sweden, among 8385 students (response rate 58.2%) in grades 7, 9, and 11, aged 13-17 years. The Strengths and Difficulties Questionnaire (SDQ) self-report was used to assess mental health problems. Gender identity was measured with one item and youth were categorized into those who identified as male or female (i.e. binary youth), and those who did or could not identify with either gender (i.e. non-binary youth). Logistic regressions and qualitative content analysis were used to analyse data.

    Results: Youth with non-binary gender identity (n = 137; 1.6%) had higher odds of having mental problems according to the SDQ total score (OR=3.05; 1.77-5.25). The association between non-binary gender identity and mental health problems remained significant after adjusting for confounders. Additionally, compared to their binary peers, the non-binary youth reported more truancy (36.5% vs 49.6%), more often failed a subject (21.5% vs 36.5%), and were more interested in exerting influence on municipal issues such as sociopolitical development, education, municipal services, and drug and alcohol policies (25.3% vs 38.0%).

    Conclusions: Youth with non-binary gender identity constitute a vulnerable population regarding mental health problems and school adjustment. The willingness to exert influence on municipal issues suggests a possible pathway to engagement.

  • 3.
    Durbeej, Natalie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    McDiarmid, Serena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Feldman, Inna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Punamäki, Raija-Leena
    Kankaanpää, Reeta
    Andersen, Arnfinn
    Hilden, Per Kristian
    Verelst, An
    Derluyn, Ilse
    Osman, Fatumo
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP. School of Education, Health and Social Studies, Dalarna University, 791 88, Falun, Sweden.
    Evaluation of a school-based intervention to promote mental health of refugee youth in Sweden (The RefugeesWellSchool Trial): study protocol for a cluster randomized controlled trial2021In: Trials, E-ISSN 1745-6215, Vol. 22, no 1, article id 98Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Sweden is home to a large and growing population of refugee youths who may be at risk of mental health problems such as post-traumatic stress disorder (PTSD). Thus, there is a need for interventions that address mental health problems in these populations. Schools have been identified as an ideal setting for delivering such interventions as they offer a non-stigmatizing space and are often central to young refugees' social networks. The RefugeesWellSchool trial in Sweden will investigate an intervention comprising two programmes: Teaching Recovery Techniques (TRT) and In-service Teacher Training (INSETT), delivered in a school setting, among refugee youth. TRT is a group-based programme for children and adolescents, informed by Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). INSETT is a multi-module course for teachers providing information on trauma and the refugee experience to build teachers' cultural competence and capacity for supporting refugee youths in schools.

    METHODS: This trial employs a cluster randomized-control design with two arms: (1) the intervention arm in which the TRT and INSETT programmes are offered (n = 350), (2) the wait-list control arm (n = 350) in which services are provided as usual until the TRT and INSETT programmes are offered approximately six months later. Data will be collected prior to the intervention, immediately following the intervention, and at three months post-intervention. Outcomes for the trial arms will be compared using linear mixed models or ANCOVA repeated measures as well as the Reliable Change Index (RCI).

    DISCUSSION: This study will provide knowledge about the effectiveness of an intervention comprising two programmes: a group-based programme for youth reporting symptoms of PTSD and a training course for teachers, in order to build their competence and ability to support refugee youths in schools.

    TRIAL REGISTRATION: ISRCTN, ISRCTN48178969 , Retrospectively registered 20/12/2019.

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  • 4.
    Durbeej, Natalie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Sörman, Karolina
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Norén Selinus, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Centre for Clinical Research, County of Västmanland. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Lundström, Sebastian
    Institute of Neuroscience and Physiology, Gillberg Neuropsychiatry Centre, Centre of Ethics Law and Mental Health, Gothenburg University, Gothenburg, Sweden.
    Lichtenstein, Paul
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Hellner, Clara
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Halldner, Linda
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Child and Adolescent Psychiatry Research center, BUP Klinisk forskningsenhet, Stockholm, Sweden; Department of Clinical Science, Child and Adolescent Psychiatry, Umeå University, SE-901 87 Umeå, Sweden.
    Trends in childhood and adolescent internalizing symptoms: results from Swedish population based twin cohorts2019In: BMC Psychology, E-ISSN 2050-7283, Vol. 7, no 1, article id 50Article in journal (Refereed)
    Abstract [en]

    Background

    Previous research has noted trends of increasing internalizing problems (e.g., symptoms of depression and anxiety), particularly amongst adolescent girls. Cross-cohort comparisons using identical assessments of both anxiety and depression in youth are lacking, however.

    Methods

    In this large twin study, we examined trends in internalizing symptoms in samples of 9 year old children and 15 year old adolescents, gathered from successive birth cohorts from 1998 to 2008 (age 9) and 1994–2001 (age 15). Assessments at age 9 were parent-rated, and at age 15 self- and parent-rated. We examined (i) the relation between birth cohorts and internalizing symptoms using linear regressions, and (ii) whether percentages of participants exceeding scale cut-off scores changed over time, using Cochrane Armitage Trend Tests.

    Results

    Among 9 year old children, a significantly increasing percentage of participants (both boys and girls) had scores above cut-off on anxiety symptoms, but not on depressive symptoms. At age 15, a significantly increasing percentage of participants (both boys and girls) had scores above cut-off particularly on self-reported internalizing symptoms. On parent-reported internalizing symptoms, only girls demonstrated a corresponding trend.

    Conclusion

    In line with previous studies, we found small changes over sequential birth cohorts in frequencies of depression and anxiety symptoms in children. Further, these changes were not exclusive to girls.

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  • 5.
    Edvinsson Sollander, Sofia
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Fabian, Helena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Salari, Raziye
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Fält, Elisabet
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Dahlberg, Anton
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Feldman, Inna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Asthma and allergies correlate to mental health problems in preschool children2021In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 110, no 5, p. 1601-1609Article in journal (Refereed)
    Abstract [en]

    AIM: To explore the relations between asthma, allergies and mental health problems in preschool children, aged 3-5-years.

    METHODS: In this cross-sectional Swedish study, we used data on 4649 children in Uppsala municipality whose parents and preschool teachers had responded to questions measuring asthma and allergies, and the Strengths and Difficulties Questionnaire (SDQ) for assessment of mental health problems. Logistic regression models were used to explore the relations between asthma and allergies and mental health problems.

    RESULTS: Children with asthma (8.5%) had elevated odds of having emotional symptoms as rated by parents (OR: 1.34; 1.02-1.76) and teachers (OR: 1.44; 1.09-1.91). According to parents' ratings, these children also had elevated odds of showing mental health problems in general according to the SDQ total score (OR: 1.42; 1.05-1.94). Children with food allergies or intolerance (4.4%) only had elevated odds of having emotional symptoms (OR: 1.64; 1.16-2.33), as reported by parents. These results remained significant after adjustment for parental background factors.

    CONCLUSION: Preschool children with asthma and food allergies or intolerance are at risk of having concurrent mental health problems. Mental health problems should be assessed in children with these disorders. Adequate support and/or referral to specialised services should be offered when needed.

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  • 6.
    Elgán, Tobias H.
    et al.
    STAD (Stockholm Prevents Alcohol and Drug Problems), Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm Stockholm Sweden.
    Durbeej, Natalie
    STAD (Stockholm Prevents Alcohol and Drug Problems), Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm Stockholm Sweden.
    Holder, Harold D.
    Prevention Research Center, PIRE (Pacific Institute for Research and Evaluation), Oakland Berkeley California USA.
    Gripenberg, Johanna
    STAD (Stockholm Prevents Alcohol and Drug Problems), Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm Stockholm Sweden.
    Effects of a multi‐component alcohol prevention intervention at sporting events: a quasi‐experimental control group study2021In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 116, no 10, p. 2663-2672Article in journal (Refereed)
  • 7.
    Fäldt, Anna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research.
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Fabian, Helena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Characteristics associated with parent’s exposure of a universal intervention to prevent language and literacy difficulties.Manuscript (preprint) (Other academic)
    Abstract [en]

    This study uses self-reported cross-sectional data to investigate which family and Swedish child health centre characteristics associated are associated with exposure to a universal intervention to prevent language and literacy difficulties, available on a digital video disc (DVD). Data were collected during three years, with 2,873 families answering a questionnaire. Only a few mothers (31%) and fathers (21%) reported that they received the intervention, and even fewer (mothers 12%, fathers 6%) reported that they had watched the intervention DVD or tried any of the activities presented in the intervention DVD (10% and 5%, respectively). Socio-demographic characteristics that were positively associated with whether parents received the intervention DVD were: being married or co-habiting, having university education or if the mother was native-born. Percentage of fathers receiving the intervention DVD differed between the child health centres. The child’s age at start of the intervention’s delivery period and the child’s birth order was also associated with whether the parent received the intervention DVD. The results indicate that the intervention seems to reach parents who are more socioeconomic advantaged, to a higher degree.

  • 8.
    Fäldt, Anna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Fabian, Helena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Family and child health centre characteristics associated with exposure to universal language and literacy promotion2023In: Child Language Teaching and Therapy, ISSN 0265-6590, E-ISSN 1477-0865, Vol. 39, no 1, p. 5-15Article in journal (Refereed)
    Abstract [en]

    Aims: This study investigated which specific socio-demographic characteristics of the family and child health service centre are associated with parents receiving a video guide. The video guide, intended to be offered universally, aimed at promoting language and literacy development.

    Methods: The video guide included language and literacy activities and was offered through child healthcare centres to all visiting families. Cross-sectional data were collected during three years through parental self-reported questionnaires when the children were three years old, and families of 2512 children were included.

    Results: In 60% of the families, none of the parents reported receiving the video guide, and in 84%, none of the parents reported that they had watched the video guide. Most of the parents who watched the video guide reported having tried the presented activities. Socio-demographic characteristics associated with parents having received the video guide were: being married or cohabiting, having a university education, or if the mother was native-born. The child's age when the video guide was initially offered and the child's birth order were also factors associated with parents having received the video guide.

    Conclusions: The results indicate that few parents overall received the video guide. Socio-economically advantaged parents seemed to have received the video guide to a higher extent.

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  • 9.
    Fäldt, Anna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research.
    Fabian, Helena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Dahlberg, Anton
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Thunberg, Gunilla
    Dart Centre for Augmentative and Alternative Communication (AAC) and Assistive Technology (AT), Sahlgrenska University Hospital, Sweden..
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Lucas, Steven
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Paediatric Inflammation, Metabolism and Child Health Research.
    Infant-Toddler Checklist identifies 18-month-old children with communication difficulties in the Swedish child healthcare setting2021In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 110, no 5, p. 1505-1512Article in journal (Refereed)
    Abstract [en]

    Aim: At present there is no reliable method to screen for communication difficulties at age 18-months in the Swedish child health care. This study examined the psychometric properties of the Communication and Symbolic Behavior Scales Developmental Profile Infant-Toddler Checklist (ITC) when used at the 18-month visit in the child health care setting.

    Method: Children aged 16 to 20 months (n=679) were screened. Children were referred for an assessment if they screened positive screen or if the parent or nurse was concerned about the child’s communicative development. Two groups of positive screens were used in the analysis (n=78 children), one based on the ITC result, and one combining the ITC with contradicting information from the nurses’ informal clinical assessment.

    Result: The AUC ranged from 0.68 to 0.84. The sensitivity was 0.85, and the specificity was 0.59. When the ITC result was combined with the nurses’ information, sensitivity increased to 0.88 and specificity to 0.63. The internal consistency was moderate to high, and fit indices were satisfactory.

    Conclusion: The results suggest that the ITC can be used to identify children in need of interventions to enhance communication at 18 months of age, especially in combination with the nurse’s assessment.

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  • 10.
    Fäldt, Anna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Nejat, Sahar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP. Paediatric Public Health Unit, Sachs Children’s Hospital , Stockholm, Sweden.
    Edvinsson Sollander, Sofia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP. Department of Pediatrics, Östersund Hospital , Östersund, Sweden;Public Health Unit, Östersund Hospital , Östersund, Sweden.
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Holmgren, Anton
    GP-GRC, Department of Paediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg , Gothenburg, Sweden;Department of Paediatrics, Halland Hospital , Halmstad, Sweden;Department of Research and Development, Region Halland , Halmstad, Sweden.
    Increased incidence of overweight and obesity among preschool Swedish children during the COVID-19 pandemic2023In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 33, no 1, p. 127-131, article id ckac181Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The COVID-19 pandemic has had wide effects on child health globally. Increased prevalence of childhood obesity has been observed by a number of countries during the pandemic. The absence of a formal societal lockdown during the pandemic, made Sweden stand out compared to other countries. This study aims to examine changes in BMI among preschool children in Sweden before and during COVID-19 pandemic.

    METHODS: Retrospective population-based cross-sectional study, with longitudinal follow-up for a portion of the children. The study included 25 049 children from three Swedish regions, with growth measures at 3- (n = 16 237), 4- (n = 14 437) and 5-years of age (n = 11 711). Care Need Index was used as a socioeconomic parameter at health centre level.

    RESULTS: There was an increase in BMI in children aged three (P = 0.028) and four (P<0.001) during the COVID-19 pandemic. Obesity in 3-year-old girls increased from 2.8% to 3.9%. Four-year-olds increased in obesity, and overweight (girls) and the prevalence of underweight decreased in boys. No change in BMI was observed in 5-year-olds. Children in areas of low socioeconomic status had higher risk of obesity.

    CONCLUSIONS: Overweight and obesity increased among 3- and 4-year-old children in Sweden, findings that were accentuated in children attending child health centres in areas with lower socioeconomic status. The COVID-19 pandemic is likely to have affected health behaviours negatively in Swedish preschool children. Our results expose the need for extended efforts directed to prevent childhood obesity, especially targeting lower socioeconomic areas.

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  • 11.
    Fält, Elisabet
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Fabian, Helena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Parental sociodemographic characteristics and mental health referrals by nurses in Swedish child health centres2022In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 111, no 9, p. 1743-1751Article in journal (Refereed)
    Abstract [en]

    Aim

    To explore the influence of parents' socio-economic characteristics on child healthcare nurses' mental health referrals of 3- to 5-year-olds and also to test the association between mental health problems and referrals.

    Methods

    Repeated cross-sectional data including parents' Strengths and Difficulties Questionnaire (SDQ) assessments and referral data (psychologist and speech and language pathologist). Hierarchical regression was used to analyse whether parents' country of birth, education level, marital status and mental health problem scores (SDQ; total difficulties and impact scores) were associated with nurses' referrals.

    Results

    About 9% of mothers and 12% of fathers rated high SDQ scores (total difficulties) in their children. Approximately, 1% of the children were referred. The influence of parents' socio-economic characteristics on referral rates was not observed. However, for children with Swedish-born mothers, referral rates were significantly lower. Scores for SDQ total difficulties and impact were associated with the child's referral to specialists.

    Conclusion

    In general, parental sociodemographic characteristics do not influence Swedish child healthcare nurses' mental health referrals. Although there was a significant association between problem behaviour and referral, a disproportion between children rated with high SDQ scores (9% and 12%) and children referred to specialists (1%) should be addressed.

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  • 12.
    Fängström, Karin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Dahlberg, Anton
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Ådahl, Kajsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Rask, Hanna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Salari, Raziye
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Is the Strengths and Difficulties Questionnaire with a Trauma Supplement a Valuable Tool in Screening Refugee Children for Mental Health Problems?2019In: The Journal of Refugee Studies, ISSN 0951-6328, E-ISSN 1471-6925, Vol. 32, no Special issue 1, p. 122-140Article in journal (Refereed)
    Abstract [en]

    The high number of asylum seekers in Sweden has highlighted the need to develop and evaluate structured assessment tools for children. In this study, we aimed to explore the utility of the Strengths and Difficulties Questionnaire (SDQ) with a trauma supplement of six items for preschool children in routine care. Parents of two- to six-year-olds (N = 61) were asked to complete the questionnaire during the routine health check-up offered to all refugees upon their arrival to Sweden. Focus-group interviews were conducted with the nurses who used the SDQ. The nurses found the SDQ valuable once they established a routine and felt that the SDQ contributed to a more structured and informative conversation about the child’s mental health. The SDQ total difficulties showed good internal consistency (alpha = 0.82). A significant proportion of children scored above the clinical cut-off and SDQ scores correlated significantly with the number of post-traumatic stress disorder symptoms measured using the supplement (rho = 0.29). The findings suggest that the SDQ with the trauma supplement is a useful tool in this clinical setting.

  • 13.
    Hermann, Veronica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Karlsson, Ann-Christin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    ‘Feeling down one evening doesn't count as having mental health problems’: Swedish adolescents' conceptual views of mental health2023In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 79, no 8, p. 2886-2899Article in journal (Refereed)
    Abstract [en]

    Aims

    To explore Swedish adolescents' conceptual views of mental health and mental health problems.

    Design

    A qualitative descriptive study design.

    Methods

    Semi-structured focus group interviews and individual interviews were conducted with, in total, 32 Swedish adolescents (15–18 years old) in October–November 2020. Data were analysed using systematic text condensation.

    Results

    Three themes were identified through the analysis: Mental health is about how we feel; One's mental health depends on one's situation, thoughts and ways of coping; and Mental health problems should be taken seriously and can get severe.

    Conclusion

    The results indicate that adolescents understand the complexity and holistic nature of mental health and mental health problems. According to the participating adolescents, positive mental health and mental health problems should be considered simultaneously to understand a young person's mental health state. Good health was described as having both absence of mental health problems and high levels of well-being: feeling well. Mental health problems were defined as something other than normal difficulties in life, but ranging from minor difficulties to more severe conditions. However, all kinds of mental health problems were termed as feeling unwell. The results suggest that adolescents are in need of support to cope with normal difficulties in life rather than lectures about life sometimes being challenging. In addition, the results highlight the need to prevent school-related stress and offer adolescents support for minor mental health problems.

    Impact

    The findings have implications for nurses and other professionals who encounter adolescents in their profession, for example specialist nurses, school nurses and public health professionals. The findings add knowledge that could be useful for communication with adolescents about their mental health and methods to assess their mental health status.

    Patient or Public Contribution

    The preliminary results were presented to three classes, in year nine in lower secondary school, for validation.

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  • 14.
    Hermann, Veronica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Karlsson, Ann-Christin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Feeling mentally unwell is the "new normal": A qualitative study on adolescents' views of mental health problems and related stigma2022In: Children and youth services review, ISSN 0190-7409, E-ISSN 1873-7765, Vol. 143, article id 106660Article in journal (Refereed)
    Abstract [en]

    Young people suffering from mental health problems is a public health issue, and it is important to listen to adolescents’ views on the issues that affect their lives. This qualitative study describes adolescents’ perceptions of the prevalence of and public stigma towards mental health problems among young people. A total of 32 Swedish adolescents, aged 15–18 years old, took part in either semi-structured focus groups or individual interviews. The data were analyzed using systematic text condensation, resulting in three themes: Having mental health problems is the new normal; What others think of you affects you; If others lack experience and knowledge, they don’t respond well. The adolescents considered mental health problems to be common in young people and a normal feature of their lives. They displayed an in-depth understanding for reasons of the increase in mental health problems in young people, and factors such as pressure from school, stereotypical gender norms, rumors and prejudice were suggested as possible explanations for the increase, alongside improved openness about mental health problems. The adolescents’ perceptions of the stigmatization of mental health problems were consistent with a trifold definition of stigma, comprising stereotypes, prejudice and discrimination. The adolescents suggested that better education about mental health problems, and more inclusive gender norms, would help reduce stigma and improve young people’s mental health.

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  • 15.
    Hermann, Veronica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Osman, Fatumo
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP. School of Health and Welfare, Dalarna University, Sweden.
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Karlsson, Ann-Christin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    How to Analyze Focus Group Interactions – Development of a Coding Scheme2024In: International Journal of Qualitative Methods, E-ISSN 1609-4069, Vol. 23Article in journal (Refereed)
    Abstract [en]

    The value of taking advantage of the participants’ interactions when analyzing focus group data is often stressed. However, there is a lack of detailed descriptions of how focus group data can be merged with interview data, and considered throughout a thematic analysis process. This article describes a systematic way to include focus group interactions in data analysis, using a coding scheme. The aim was threefold: to develop a coding scheme for focus group interactions; to test and describe a process for interaction analysis, merged into the thematic data analysis process, and to test the coding scheme on another dataset. Based on focus group literature a comprehensive coding scheme for analyzing focus group interactions, was developed, including symbols for these interactions. Data from five focus group interviews involving adolescents were subsequently coded using this scheme. Further analysis of the identified interactions was conducted simultaneously with thematic data analysis, using Systematic Text Condensation (STC) as an illustrative method. The coding scheme was then tested on data from a different focus group involving adolescents in another setting. A comparison between the two coders was made, leading to a slight modification of the coding scheme. The resulting coding scheme is a practical tool adding to the previous knowledge on focus group interaction analysis. More specifically, the scheme facilitates focus group interactions to be visible and accounted for thought the thematic analysis process.

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  • 16.
    Hermann, Veronica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Söderqvist, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Centre for Clinical Research, County of Västmanland. University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro Sweden.
    Karlsson, Ann-Christin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Mental health status according to the dual-factor model in Swedish adolescents: A cross sectional study highlighting associations with stress, resilience, social status and gender2024In: PLOS ONE, E-ISSN 1932-6203, Vol. 19, no 3, article id e0299225Article in journal (Refereed)
    Abstract [en]

    In this cross-sectional study, we aimed to I) investigate the dual-factor model of mental health by forming and describing four participant groups and II) examine associations between mental health status and background factors, school-related factors, stress, and resilience among adolescents in a community population in Sweden. Data were collected through a survey completed by 2,208 students in lower and upper secondary school on the Swedish island of Gotland. After missing data were removed, a total of 1,833 participants were included in the study. The survey included the Mental Health Continuum Short Form (MHC-SF) for the assessment of mental well-being and the Strengths and Difficulties Questionnaire (SDQ) for the assessment of mental health problems. These two measures were combined into a dual-factor model, forming four mental health status subgroups: Vulnerable (47.5%), Complete mental health (36.2%), Troubled (13.9%), and Symptomatic but content (2.5%). Associations between these groups were explored regarding background factors, school-related factors, stress, and resilience through chi-squared tests and logistic regressions. Girls (OR: 1.88) and participants with high stress levels (OR: 2.23) had elevated odds for Vulnerable mental health status, whereas higher resilience (OR: 0.87) and subjective social status in school (OR: 0.76) were factors associated with reduced odds for this mental health status classification. Female gender (OR: 5.02) was also associated with Troubled mental health status. Similarly, a high level of stress (ORs: 4.08 and 11.36) was associated with Symptomatic but content and Troubled mental health status, and participants with higher levels of resilience had decreased odds for being classified into these groups (ORs: 0.88 and 0.81). The findings highlight the importance of interventions to increase resilience, reduce stress, and address stereotypic gender norms as well as social status hierarchies to support adolescents’ mental health.

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  • 17.
    Johansson, Viktoria
    et al.
    Karolinska Inst, Stockholm, Sweden.;Stockholm Cty Council, Stockholm, Sweden..
    Noren Selinus, Eva
    Karolinska Inst, Ctr Psychiat Res, Stockholm, Sweden.;Stockholm Cty Council, Stockholm, Sweden..
    Kuja-Halkola, Ralf
    Karolinska Inst, Stockholm, Sweden..
    Lundström, Sebastian
    Univ Gothenburg, Gothenburg, Sweden..
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP. Karolinska Inst, Stockholm, Sweden..
    Anckarsäter, Henrik
    Univ Gothenburg, Sahlgrenskas Acad, Forens Psychiat, Gothenburg, Sweden..
    Lichtenstein, Paul
    Karolinska Inst, Genet Epidemiol, Stockholm, Sweden..
    Hellner, Clara
    Karolinska Inst, Stockholm, Sweden.;Stockholm Cty Council, Stockholm, Sweden..
    The Quantified Behavioral Test Failed to Differentiate ADHD in Adolescents With Neurodevelopmental Problems2021In: Journal of Attention Disorders, ISSN 1087-0547, E-ISSN 1557-1246, Vol. 25, no 3, p. 312-321Article in journal (Refereed)
    Abstract [en]

    Objective: The Quantified Behavioral Test (QbTest) is a computerized diagnostic test for ADHD, used in clinical psychiatric care, but its validity may be questioned. We analyzed the QbTest's diagnostic validity and its relation to cognitive ability and psychosocial factors in an adolescent population with a high occurrence of neurodevelopmental disorders.

    Method: In total, 340 participants aged 15 years, completed the QbTest, along with questionnaires, clinical and intelligence quotient (IQ) assessments.

    Results: The clinical assessment resulted in 89 (26%) participants with ADHD. Area under curve (AUC) scores indicated a random to poor validity of the QbTest (AUC range = 0.48-0.64). QbTest scores of inattention and impulsivity correlated with IQ.

    Conclusion: The QbTest was insufficient as a diagnostic test for ADHD, and was not able to differentiate ADHD from other neurodevelopmental conditions. Clinicians should be aware of the dubious discriminating power of the QbTest.

  • 18.
    Kankaanpää, Reeta
    et al.
    Tampere Univ, Fac Social Sci, Psychol, Tampere, Finland.;Univ Turku, INVEST Res Flagship Ctr, Turku, Finland.;Tampere Univ, Fac Social Sci Psychol, Tampere FIN-33014, Finland..
    Vänskä, Mervi
    Tampere Univ, Fac Social Sci, Psychol, Tampere, Finland..
    Opaas, Marianne
    Norwegian Ctr Violence & Traumat Stress Studies, NKVTS, Oslo, Norway..
    Spaas, Caroline
    Univ Leuven, Fac Psychol & Educ Sci, Parenting & Special Educ Res Unit, Leuven, Belgium..
    Derluyn, Ilse
    Univ Ghent, Ctr Social Study Migrat & Refugees, Dept Social Work & Social Pedag, Ghent, Belgium..
    Jervelund, Signe Smith
    Univ Copenhagen, Dept Publ Hlth, Copenhagen, Denmark..
    Skovdal, Morten
    Univ Copenhagen, Dept Publ Hlth, Copenhagen, Denmark..
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Osman, Fatumo
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP. Dalarna Univ, Sch Hlth & Welf, Falun, Sweden..
    De Haene, Lucia
    Univ Leuven, Fac Psychol & Educ Sci, Parenting & Special Educ Res Unit, Leuven, Belgium..
    de Smet, Sofie
    Univ Leuven, Fac Psychol & Educ Sci, Parenting & Special Educ Res Unit, Leuven, Belgium..
    Andersen, Arnfinn J.
    Norwegian Ctr Violence & Traumat Stress Studies, NKVTS, Oslo, Norway..
    Hilden, Per Kristian
    Norwegian Ctr Violence & Traumat Stress Studies, NKVTS, Oslo, Norway..
    Verelst, An
    Univ Ghent, Ctr Social Study Migrat & Refugees, Dept Social Work & Social Pedag, Ghent, Belgium..
    Peltonen, Kirsi
    Univ Turku, INVEST Res Flagship Ctr, Turku, Finland..
    Psychometric properties of the Children's Revised Impact of Event Scale (CRIES-8) among refugee adolescents from Afghanistan, Syria, and Somalia2024In: European Journal of Psychotraumatology, ISSN 2000-8198, E-ISSN 2000-8066, Vol. 15, no 1, article id 2349445Article in journal (Refereed)
    Abstract [en]

    Background: High levels of post-traumatic stress are well documented among refugees. Yet, refugee adolescents display high heterogeneity in their type of trauma and symptom levels.

    Objective: Following the recurrent plea for validated trauma screening tools, this study investigated the psychometric properties of the Children’s Revised Impact of Event Scale (CRIES-8) among refugee adolescents from Afghanistan (n = 148), Syria (n = 234), and Somalia (n = 175) living in Europe.

    Method: The model fit for the confirmatory factor structures was tested, as well as measurement invariance between the three groups. The robustness of results was evaluated by testing measurement invariance between recently arrived and settled adolescents, and between different response labelling options. Reliability (α, ω, and ordinal α), criterion validity, and prevalence estimates were calculated.

    Results: The intrusion subscale showed a better stable model fit than the avoidance subscale, but the two-factor structure was mainly supported. Configural measurement invariance was achieved between Afghan and Somali adolescents, and strong measurement invariance between Syrian and Somali adolescents. The results were robust considering the time living in the host country and response labelling styles. Reliability was low among Afghan and Syrian adolescents (.717−.856), whereas it was higher among Somali adolescents (.831−.887). The total score had medium-sized correlations with emotional problems (.303−.418) and low correlations with hyperactivity (.077−.155). There were statistically significant differences in symptom prevalence: Afghan adolescents had higher prevalence (55.5%) than Syrian (42.8%) and Somali (37%) adolescents, and unaccompanied refugee minors had higher symptom prevalence (63.5%) than accompanied adolescents (40.7%).

    Conclusions: This study mostly supports the use of the CRIES-8 among adolescents from Afghanistan, Syria, and Somalia, and even comparative analyses of group means. Variation in reliability estimates, however, makes diagnostic predictions difficult, as the risk of misclassification is high.

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  • 19.
    Marchi, Mattia
    et al.
    Univ Modena & Reggio Emilia, Dept Biomed Metab & Neural Sci, Via Giuseppe Campi 287, I-41125 Modena, Italy.;Azienda USL IRCCS Reggio Emilia, Dipartimento Salute Mentale & Dipendenze Patol, Via Giovanni Amendola 2, I-42122 Reggio Emilia, Italy..
    Magarini, Federica Maria
    Univ Modena & Reggio Emilia, Dept Biomed Metab & Neural Sci, Via Giuseppe Campi 287, I-41125 Modena, Italy..
    Chiarenza, Antonio
    Univ Modena & Reggio Emilia, Dept Biomed Metab & Neural Sci, Via Giuseppe Campi 287, I-41125 Modena, Italy..
    Galeazzi, Gian Maria
    Univ Modena & Reggio Emilia, Dept Biomed Metab & Neural Sci, Via Giuseppe Campi 287, I-41125 Modena, Italy.;Azienda USL IRCCS Reggio Emilia, Dipartimento Salute Mentale & Dipendenze Patol, Via Giovanni Amendola 2, I-42122 Reggio Emilia, Italy..
    Paloma, Virginia
    Univ Seville, Dept Social Psychol, Seville 41018, Spain..
    Garrido, Rocio
    Univ Seville, Dept Social Psychol, Seville 41018, Spain..
    Ioannidi, Elisabeth
    Acad Athens, Res Ctr Greek Soc, Athens 15126, Greece..
    Vassilikou, Katerina
    Acad Athens, Res Ctr Greek Soc, Athens 15126, Greece..
    de Matos, Margarida Gaspar
    Univ Lisbon, Inst Environm Hlth ISAMB, Lisbon, Portugal..
    Gaspar, Tania
    Univ Lisbon, Inst Environm Hlth ISAMB, Lisbon, Portugal..
    Guedes, Fabio Botelho
    Univ Lisbon, Inst Environm Hlth ISAMB, Lisbon, Portugal..
    Primdahl, Nina Langer
    Univ Copenhagen, Dept Publ Hlth, DK-1014 Copenhagen, Denmark..
    Skovdal, Morten
    Univ Copenhagen, Dept Publ Hlth, DK-1014 Copenhagen, Denmark..
    Murphy, Rebecca
    Maynooth Univ, Dept Psychol, Maynooth W23 F2K8, Kildare, Ireland..
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Osman, Fatumo
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP. Dalarna Univ, Sch Hlth & Welf, Hogskolegatan 2, S-79188 Falun, Sweden..
    Watters, Charles
    Univ Sussex, Dept Sch Educ & Social Work, Sussex, England..
    van den Muijsenbergh, Maria
    Radboud Univ Nijmegen, Dept Primary & Community Care, NL-6500 HB Nijmegen, Netherlands..
    Sturm, Gesine
    Univ Toulouse 2, Dept Clin Sujet, LCPI Lab, F-31058 Toulouse, France..
    Oulahal, Rachid
    Reunion Univ FR, DIRE Res Ctr, French Collaborat Inst Migrat, CS 92003,15 Ave Rene Cassin, F-97400 St Denis 9, Reunion, France..
    Padilla, Beatriz
    Univ S Florida, Dept Sociol, Tampa, FL 33620 USA..
    Willems, Sara
    Univ Ghent, Dept Publ Hlth & Primary Care, Qual & Safety Ghent, B-9000 Ghent, Belgium..
    Spiritus-Beerden, Eva
    Univ Ghent, Dept Social Work & Social Pedag, B-9000 Ghent, Belgium..
    Verelst, An
    Univ Ghent, Dept Social Work & Social Pedag, B-9000 Ghent, Belgium..
    Derluyn, Ilse
    Univ Ghent, Dept Social Work & Social Pedag, B-9000 Ghent, Belgium..
    Experience of discrimination during COVID-19 pandemic: the impact of public health measures and psychological distress among refugees and other migrants in Europe2022In: BMC Public Health, E-ISSN 1471-2458, Vol. 22, article id 942Article in journal (Refereed)
    Abstract [en]

    Background: The COVID-19 pandemic has had a disproportionately hard impact on refugees and other migrants who are often exposed to the virus with limited means to protect themselves. We tested the hypothesis that during the COVID-19 pandemic, refugees and other migrants have suffered a negative impact on mental health and have been unjustly discriminated for spreading the disease in Europe (data collection from April to November 2020).

    Methods: Participants in the ApartTogether Survey (N = 8297, after listwise deletion of missing items final N = 3940) provided data regarding to their difficulties to adhere to preventive recommendations against COVID-19 infection (CARE), self-perceived stigmatization (SS), and psychological distress (PD). Structural Equation Modeling was used to investigate PD as a mediator in the pathway linking CARE to SS, while adjusting for the housing and residence status. To improve confidence in the findings, single hold-out sample cross-validation was performed using a train/test split ratio of 0.8/0.2.

    Results: In the exploratory set (N = 3159) SS was associated with both CARE (B = 0.200, p < 0.001) and PD (B = 0.455, p < 0.001). Moreover, PD was also associated with CARE (B = 0.094, p = 0.001) and mediated the effect of CARE on SS (proportion mediated = 17.7%, p = 0.001). The results were successfully replicated in the confirmation set (N = 781; total effect = 0.417, p < 0.001; proportion mediated = 29.7%, p < 0.001). Follow-up analyses also found evidence for an opposite effect (i.e., from SS to CARE, B = 0.132; p < 0.001), suggesting that there might be a vicious circle between the self-perceived stigmatization and the access to health care and the use of preventive measures against COVID-19 infection.

    Conclusions: Refugees and other migrants who had more difficulties in accessing health care and preventive measures against COVID-19 infection experienced worse mental health and increased discrimination. These negative effects appeared to be stronger for those with more insecure housing and residence status, highlighting from one side the specific risk of insecure housing in the impact of COVID-19 upon mental health and infection protection, and for another side the need to proper housing as a strategy to prevent both COVID-19 and mental distress.

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  • 20.
    Marshall, John J.
    et al.
    Univ Glasgow, Inst Hlth & Wellbeing, Glasgow, Lanark, Scotland..
    Sörman, Karolina
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden..
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP. Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden..
    Thompson, L.
    Univ Glasgow, Inst Hlth & Wellbeing, Glasgow, Lanark, Scotland.;Gothenburg Univ, Sahlgrenska Acad, Gillberg Neuropsychiat Ctr, Glasgow, Lanark, Scotland..
    Lundström, Sebastian
    Gothenburg Univ, Inst Neurosci & Physiol, Gillberg Neuropsychiat Ctr, Ctr Eth Law & Mental Hlth, Gothenburg, Sweden..
    Minnis, Helen
    Univ Glasgow, Inst Hlth & Wellbeing, Glasgow, Lanark, Scotland..
    Hellner, Clara
    Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden..
    Gillberg, Christopher
    Univ Glasgow, Inst Hlth & Wellbeing, Glasgow, Lanark, Scotland.;Gothenburg Univ, Sahlgrenska Acad, Gillberg Neuropsychiat Ctr, Glasgow, Lanark, Scotland..
    Interpersonal trauma and its relation to childhood psychopathic traits: what does ADHD and ODD add to the equation?2021In: BMC Psychiatry, E-ISSN 1471-244X, Vol. 21, no 1, article id 630Article in journal (Refereed)
    Abstract [en]

    Background Childhood trauma has demonstrated associations with callous-unemotional traits (e.g., reflecting lack of remorse and guilt, unconcern about own performance). Less is known about associations between trauma and multiple domains of child psychopathic traits. There has also been limited focus on the role of co-occurring disorders to psychopathy traits among children, namely, attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) and how they interact with childhood trauma. Methods We examined to what degree childhood interpersonal trauma can predict parent-rated psychopathic traits in a large population based Swedish twin sample (N = 5057), using a stringent definition of interpersonal trauma occurring before age 10. Two hundred and fifty-one participants met the interpersonal trauma criteria for analysis. The study explored the additional impact of traits of attention-deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). Results Linear regressions demonstrated statistically significant but clinically negligible effects of interpersonal trauma on total and subscale scores of parent-rated psychopathic traits. When exploring interaction effects of ADHD and ODD into the model, the effect increased. There were interaction effects between ODD and trauma in relation to psychopathic traits, suggesting a moderating role of ODD. Having been exposed to trauma before age 10 was significantly associated with higher parent rated psychopathy traits as measured by The Child Problematic Traits Inventory-Short Version (CPTI-SV), however the explained variance was small (0.3-0.9%). Conclusions The results challenge the notion of association between interpersonal trauma and youth psychopathic traits. They also highlight the need to gain an improved understanding of overlap between psychopathic traits, ADHD and ODD for clinical screening purposes and the underlying developmental mechanisms.

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  • 21.
    McDiarmid, Serena
    et al.
    Univ Waterloo, Dept Psychol, Waterloo, ON, Canada..
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Osman, Fatumo
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP. Dalarna Univ, Dept Hlth & Welf, Falun, Sweden..
    Schools' and teachers' roles and challenges in supporting the mental wellbeing of refugee youths: a qualitative study with Swedish teachers2022In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 17, no 1, article id 2007568Article in journal (Refereed)
    Abstract [en]

    Purpose Resettled refugee youths are increasingly entering host-country school systems and are at risk of poor mental wellbeing. Schools and teachers are often expected to provide psychosocial support to youths with refugee backgrounds, but the teachers' views on this expectation are poorly understood. We investigated the question: What do Swedish teachers believe is the role of (1) schools and (2) teachers in supporting refugee youths' mental wellbeing? Method Four semi-structured focus groups were conducted with 30 Swedish educators from five schools. Interview transcripts were analysed and themes reflecting the key concepts were constructed using reflexive thematic analysis. Results Seven themes were constructed. Three addressed the role of schools in supporting refugee youths' mental wellbeing: Promoting Belonging, Offering Refuge, and Instilling Civic Literacy. Four addressed the role of teachers: Building Relationships with Students, Maintaining a Non-therapeutic Relationship, Connecting to Professionals, and Instructing in the Classroom. Conclusion Teachers believe that both schools and teachers play an important role in supporting refugee youths' mental wellbeing and each contributes in unique ways. However, schools and teachers are not always successful in supporting refugee youth and teachers reported facing challenges such as unclear roles and a lack of resources.

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  • 22.
    McDiarmid, Serena
    et al.
    Univ Waterloo, Dept Psychol, Waterloo, ON, Canada..
    Osman, Fatumo
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Associations between social factors and school belonging among newcomer and non-newcomer youth in Sweden2023In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 2, article id e0280244Article in journal (Refereed)
    Abstract [en]

    Feeling a sense of belonging at school is associated with important positive outcomes for youth and requires youth to engage in positive social relationships. Yet there is a limited understanding of the social factors most associated with youths' school belonging and limited evidence about whether correlates of school belonging vary for marginalized groups like newcomers compared to majority groups. Sweden provides an important context for investigation of these issues because, over the past two decades, the country has experienced an influx of asylum seekers and educational reforms that have altered the composition and functioning of Swedish secondary schools. This study addresses these gaps by (1) investigating which of eight social factors are associated with school belonging among diverse Swedish youth, and (2) examining whether newcomer status moderates the relationship between social factors and school belonging. Hierarchical regression and moderation analyses were used to analyze data from 14 to 19 year-old (n = 233) newcomers and non-newcomers in Sweden. An exploratory factor analysis revealed that the school belonging measure contained two factors: positive perceptions and negative perceptions (reverse coded). For both, stronger school belonging was associated with lower perceived ethnic discrimination. Positive perceptions of school belonging were also associated with more prosocial behaviours and lower emotional problems. Negative perceptions of school belonging were associated with more peer problems. Notably, quantity and quality of peer relationships were not associated with school belonging. There was no consistent evidence of newcomer status moderating the relationship between social factors and school belonging. These results highlight factors associated with school belonging which are modifiable and amenable to intervention or impact by policy-ethnic discrimination, prosocial behaviour, and emotional and peer problems. The absence of moderation by newcomer status suggests that school belonging interventions or related policies are likely to affect newcomer and non-newcomer students similarly.

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  • 23.
    Nystrand, Camilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Osman, Fatumo
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP. Dalarna Univ, Sch Educ Hlth & Social Studies, Falun, Sweden..
    Lindell, Charles
    Right By Me, Stockholm, Sweden..
    Olsson, Frida
    Right By Me, Stockholm, Sweden..
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Predisposing, need and enabling factors for service utilization amongst newly arrived youth in Sweden2023In: International Journal of Migration, Health and Social Care, ISSN 1747-9894, E-ISSN 2042-8650, Vol. 19, no 3/4, p. 351-362Article in journal (Refereed)
    Abstract [en]

    Purpose: The reasons for and experiences during migration, as well as additional stressors in the new host country, may give rise to mental health problems and additional need for public services. The purpose of the study was to investigate factors related to service utilization among newly arrived refugee youth.

    Design/methodology/approach: Cross-sectional data were gathered in Sweden where 37 youth aged between 19 and 23 reported on factors related to service utilization, encompassing health-care and support services in school. These factors included predisposition (demographic), need (migration status and mental wellbeing) and enablement (living situation). Service utilization was estimated using multiple logistic regression analysis.

    Findings: About a fourth of the sample used psychosocial services. Use of general support was more common. Neither predisposing, need nor enabling factors were associated with the use of psychosocial or general health-related services.

    Originality/value: Self-reported factors related to use of health-related services have previously not been investigated for refugee youth, which is important in assuring access to appropriate services for this exposed youth population.

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  • 24.
    Sarkadi, Anna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Warner, Georgina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Salari, Raziye
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Fängström, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Lampa, Elin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Baghdasaryan, Zaruhi
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Osman, Fatumo
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Gupta Löfving, Sandra
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Perez Aronsson, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Feldman, Inna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Sampaio, Filipa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Ssegonja, Richard
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Calam, Rachel
    Division of Clinical Psychology, University of Manchester, Manchester, UK.
    Bjärtå, Anna
    Department of Psychology, Mid-Sweden University, Östersund, Sweden.
    Leiler, Anna
    Department of Psychology, Mid-Sweden University, Östersund, Sweden.
    Rondung, Elisabet
    Department of Psychology, Mid-Sweden University, Östersund, Sweden.
    Wasteson, Elisabet
    Department of Psychology, Mid-Sweden University, Östersund, Sweden.
    Oppedal, Brit
    Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway.
    Keeshin, Brooks
    Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA.
    Evaluation of the Teaching Recovery Techniques community-based intervention for unaccompanied refugee youth experiencing post-traumatic stress symptoms (Swedish UnaccomPanied yOuth Refugee Trial; SUPpORT): study protocol for a randomised controlled trial2020In: Trials, E-ISSN 1745-6215, Vol. 21, no 1, article id 63Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In 2015, 162,877 persons sought asylum in Sweden, 35,369 of whom were unaccompanied refugee minors (URMs). Refugee children, especially URMs, have often experienced traumas and are at significant risk of developing mental health problems, such as symptoms of post-traumatic stress disorder (PTSD), depression and anxiety, which can continue years after resettlement. The Swedish UnaccomPanied yOuth Refugee Trial (SUPpORT) aims to evaluate a community-based intervention, called Teaching Recovery Techniques (TRT), for refugee youth experiencing PTSD symptoms.

    METHODS/DESIGN: A randomised controlled trial will be conducted in which participants will be randomly allocated to one of two possible arms: the intervention arm (n = 109) will be offered the TRT programme, and the waitlist-control arm (n = 109) will receive services as usual, followed by the TRT programme around 20 weeks later. Outcome data will be collected at three points: pre-intervention (T1), post-intervention (T2; about 8 weeks after randomisation) and follow-up (T3; about 20 weeks after randomisation).

    DISCUSSION: This study will provide knowledge about the effect and efficiency of a group intervention for URMs reporting symptoms of PTSD in Sweden.

    TRIAL REGISTRATION: ISRCTN, ISRCTN47820795. Prospectively registered on 20 December 2018.

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  • 25.
    Selinus, Eva Noren
    et al.
    Reg Vastmanland Uppsala Univ, Vastmanland Hosp Västerås, Ctr Clin Res, Uppsala, Sweden.;Swedish Sch Sport & Hlth Sci, Stockholm, Sweden..
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP. Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res & Educ, Stockholm, Sweden.;Stockholm Cty Council, Stockholm, Sweden.;Uppsala Univ, Dept Publ Hlth & Caring Sci, Child Hlth & Parenting CHAP, Uppsala, Sweden..
    Zhan, Yiqiang
    German Ctr Neurogenerat Dis, Ulm, Germany.;Karolinska Inst, Inst Environm Med, Stockholm, Sweden..
    Lichtenstein, Paul
    Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden..
    Lundstrom, Sebastian
    Univ Gothenburg, Ctr Eth Law & Mental Hlth CELAM, Gothenburg, Sweden.;Univ Gothenburg, Gillberg Neuropsychiat Ctr, Gothenburg, Sweden..
    Ekblom, Maria
    Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res & Educ, Stockholm, Sweden.;Stockholm Cty Council, Stockholm, Sweden.;Karolinska Inst, Dept Neurosci, Stockholm, Sweden..
    Inattention and hyperactivity symptoms in childhood predict physical activity in adolescence2021In: BMC Psychiatry, E-ISSN 1471-244X, Vol. 21, no 1, article id 629Article in journal (Refereed)
    Abstract [en]

    Background Physical activity has been documented to influence several aspects of physical and mental health. Growing evidence shows that physical activity can improve attention. Less is known about how symptoms of inattention and hyperactivity / impulsivity in childhood are associated with physical activity in adolescence. We aimed to explore this relationship further. Methods We used a cohort of 3949 Swedish children (1884 boys and 2065 girls) with data collected at ages 9 (or 12) and 15. We investigated the influence of symptoms of inattention and hyperactivity / impulsivity in childhood - age 9/12 (inattention and hyperactivity/impulsivity separately) on self-rated physical activity at age 15, using multiple logistic regression models. We considered potential confounders such as sex, parental education level, physical activity in childhood and neurodevelopmental comorbidity. A cluster robust sandwich estimator was applied to adjust the standard errors for the nested twin data when computing the regression models. Results Symptoms of inattention in childhood (9/12) predicted less physical activity in adolescence (age 15) (OR = 0.83 CI = 0.78-0.89), whereas the opposite was true for hyperactivity/impulsivity (OR = 1.08 CI = 1.02-1.10). These associations still remained when taking possible confounders into account including neurodevelopmental and neurodevelopmental related comorbidity. Conclusions These findings support the importance of helping children and adolescents with inattention symptoms to engage in physical activity in suitable settings.

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  • 26.
    Skott, Maria
    et al.
    Karolinska Inst, Dept Clin Neurol Sci, Ctr Psychiat Res, S-11763 Stockholm, Sweden.;Stockholm Cty Council, Stockholm Hlth Care Serv, Stockholm, Sweden..
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP. Karolinska Inst, Dept Clin Neurol Sci, Ctr Psychiat Res, S-11763 Stockholm, Sweden.;Uppsala Univ, Dept Publ Hlth & Caring Sci, Child Hlth & Parenting, Uppsala, Sweden..
    Smitmanis-Lyle, Maria
    Karolinska Inst, Dept Clin Neurol Sci, Ctr Psychiat Res, S-11763 Stockholm, Sweden.;Stockholm Cty Council, Stockholm Hlth Care Serv, Stockholm, Sweden..
    Hellner, Clara
    Karolinska Inst, Dept Clin Neurol Sci, Ctr Psychiat Res, S-11763 Stockholm, Sweden.;Stockholm Cty Council, Stockholm Hlth Care Serv, Stockholm, Sweden..
    Allenius, Emelie
    Karolinska Inst, Dept Clin Neurol Sci, Ctr Psychiat Res, S-11763 Stockholm, Sweden.;Stockholm Cty Council, Stockholm Hlth Care Serv, Stockholm, Sweden..
    Salomonsson, Sigrid
    Karolinska Inst, Dept Clin Neurol Sci, Ctr Psychiat Res, S-11763 Stockholm, Sweden.;Stockholm Cty Council, Stockholm Hlth Care Serv, Stockholm, Sweden..
    Lundgren, Tobias
    Karolinska Inst, Dept Clin Neurol Sci, Ctr Psychiat Res, S-11763 Stockholm, Sweden.;Stockholm Cty Council, Stockholm Hlth Care Serv, Stockholm, Sweden..
    Jayaram-Lindström, Nitya
    Karolinska Inst, Dept Clin Neurol Sci, Ctr Psychiat Res, S-11763 Stockholm, Sweden.;Stockholm Cty Council, Stockholm Hlth Care Serv, Stockholm, Sweden..
    Rozental, Alexander
    Karolinska Inst, Dept Clin Neurol Sci, Ctr Psychiat Res, S-11763 Stockholm, Sweden.;Stockholm Cty Council, Stockholm Hlth Care Serv, Stockholm, Sweden.;UCL, Great Ormond St Hosp Inst Child Hlth, London, England..
    Patient-controlled admissions to inpatient care: A twelve-month naturalistic study of patients with schizophrenia spectrum diagnoses and the effects on admissions to and days in inpatient care2021In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 21, article id 598Article in journal (Refereed)
    Abstract [en]

    Background: Patients with schizophrenia spectrum diagnoses have a poor prognostic outlook and rates of recovery. Inpatient care is common, but the decision to initiate such care is not solely up to the patient but also influenced by the healthcare providers. Recent ideas about shared decision-making however challenges this idea. Patient-Controlled Admissions (PCA) refers to a care model where a patient signs a contract that allows the decision for admission into inpatient care to be transferred onto the patient.

    Methods: In Region Stockholm's public healthcare PCA was introduced to patients with schizophrenia spectrum diagnoses deemed to have the greatest care needs. Outcomes of a 12-month naturalistic within-group follow-up was analyzed using Wilcoxon signed-rank test.

    Results: In total, 56 patients fulfilled the study's inclusion criteria, with between 20 to 42 patients having complete data and being able to analyze statistically, depending on the variable. Number of admissions, inpatient days, number of involuntary admissions, and involuntary admission days decreased, but only significantly so for inpatient days, p < .01 (a mean reduction of 11.5 days). Neither self-rated well-being, as assessed using the EQ5D-3L, or a clinician-administered rating of overall health status, the Clinical Global Impression Scale, demonstrated a significant change.

    Conclusions: The use of PCA points towards a trend in decreased hospitalization for patients with schizophrenia spectrum diagnoses, although this needs to be explored further in larger samples and over a longer follow-up.

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  • 27. Spaas, Caroline
    et al.
    Verelst, An
    Devlieger, Ines
    Aalto, Sanni
    Andersen, Arnfinn J
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Hilden, Per Kristian
    Kankaanpää, Reeta
    Primdahl, Nina Langer
    Opaas, Marianne
    Osman, Fatumo
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Peltonen, Kirsi
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Skovdal, Morten
    Jervelund, Signe Smith
    Soye, Emma
    Watters, Charles
    Derluyn, Ilse
    Colpin, Hilde
    De Haene, Lucia
    Mental Health of Refugee and Non-refugee Migrant Young People in European Secondary Education: The Role of Family Separation, Daily Material Stress and Perceived Discrimination in Resettlement.2022In: Journal of Youth and Adolescence, ISSN 0047-2891, E-ISSN 1573-6601, Vol. 51, no 5, p. 848-870Article in journal (Refereed)
    Abstract [en]

    While scholarly literature indicates that both refugee and non-refugee migrant young people display increased levels of psychosocial vulnerability, studies comparing the mental health of the two groups remain scarce. This study aims to further the existing evidence by examining refugee and non-refugee migrants' mental health, in relation to their migration history and resettlement conditions. The mental health of 883 refugee and 483 non-refugee migrants (mean age 15.41, range 11-24, 45.9% girls, average length of stay in the host country 3.75 years) in five European countries was studied in their relation to family separation, daily material stress and perceived discrimination in resettlement. All participants reported high levels of post-traumatic stress symptoms. Family separation predicted post-trauma and internalizing behavioral difficulties only in refugees. Daily material stress related to lower levels of overall well-being in all participants, and higher levels of internalizing and externalizing behavioral difficulties in refugees. Perceived discrimination was associated with increased levels of mental health problems for refugees and non-refugee migrants. The relationship between perceived discrimination and post-traumatic stress symptoms in non-refugee migrants, together with the high levels of post-traumatic stress symptoms in this subsample, raises important questions on the nature of trauma exposure in non-refugee migrants, as well as the ways in which experiences of discrimination may interact with other traumatic stressors in predicting mental health.

  • 28.
    Spiritus-Beerden, Eva
    et al.
    Univ Ghent, Dept Social Work & Social Pedag, B-9000 Ghent, Belgium..
    Verelst, An
    Univ Ghent, Dept Social Work & Social Pedag, B-9000 Ghent, Belgium..
    Devlieger, Ines
    Univ Ghent, Dept Social Work & Social Pedag, B-9000 Ghent, Belgium..
    Langer Primdahl, Nina
    Univ Copenhagen, Dept Publ Hlth, DK-1014 Copenhagen, Denmark..
    Botelho Guedes, Fabio
    Univ Lisbon, Dept Hlth Educ, P-1400 Lisbon, Portugal..
    Chiarenza, Antonio
    Univ Modena & Reggio Emilia, Dept Biomed Metabol & Neurosci, I-41125 Modena, Italy..
    De Maesschalck, Stephanie
    Univ Ghent, Dept Publ Hlth & Primary Care, B-9000 Ghent, Belgium..
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Garrido, Rocio
    Univ Seville, Dept Social Psychol, Seville 41018, Spain..
    Gaspar de Matos, Margarida
    Univ Lisbon, Dept Hlth Educ, P-1400 Lisbon, Portugal..
    Ioannidi, Elisabeth
    Natl & Kapodistrian Univ Athens, Inst Discourse Res Lab, Athens 14122, Greece..
    Murphy, Rebecca
    Maynooth Univ, Dept Psychol, Kildare W23 F2K8, Ireland..
    Oulahal, Rachid
    La Reun Univ, DIRE Lab, Dept Social Sci, F-97400 St Denis, France..
    Osman, Fatumo
    Dalarna Univ, Sch Hlth & Welf, S-79188 Falun, Sweden..
    Padilla, Beatriz
    Univ S Florida, Dept Sociol, Tampa, FL 33620 USA.;ISCTE IUL, P-1649026 Lisbon, Portugal..
    Paloma, Virginia
    Univ Seville, Dept Social Psychol, Seville 41018, Spain..
    Shehadeh, Amer
    AL Istiqlal Univ, Dept Psychol, Jericho 580 P, Palestine;..
    Sturm, Gesine
    Univ Toulouse, Dept Psychol, F-31058 Toulouse, France..
    van den Muijsenbergh, Maria
    Radboud Univ Nijmegen, Dept Primary & Community Care, N-6500 Nijmegen, Netherlands..
    Vasilikou, Katerina
    Acad Athens, Res Ctr Greek Soc, Athens 15126, Greece..
    Watters, Charles
    Univ Sussex, Dept Sch Educ & Social Work, Sussex BN1 4GE, England..
    Willems, Sara
    Univ Ghent, Dept Publ Hlth & Primary Care, B-9000 Ghent, Belgium..
    Skovdal, Morten
    Univ Copenhagen, Dept Publ Hlth, DK-1014 Copenhagen, Denmark..
    Derluyn, Ilse
    Univ Ghent, Dept Social Work & Social Pedag, B-9000 Ghent, Belgium..
    Mental Health of Refugees and Migrants during the COVID-19 Pandemic: The Role of Experienced Discrimination and Daily Stressors2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 12, article id 6354Article in journal (Refereed)
    Abstract [en]

    The COVID-19 pandemic is a defining global health crisis of our time. While the impact of COVID-19, including its mental health impact, is increasingly being documented, there remain important gaps regarding the specific consequences of the pandemic on particular population groups, including refugees and migrants. This study aims to uncover the impact of the COVID-19 pandemic on the mental health of refugees and migrants worldwide, disentangling the possible role of social and daily stressors, i.e., experiences of discrimination and daily living conditions. Descriptive analysis and structural equation modeling were used to analyze the responses of N = 20,742 refugees and migrants on the self-reporting global ApartTogether survey. Survey findings indicated that the mental health of refugees and migrants during the COVID-19 pandemic was significantly impacted, particularly for certain subgroups, (i.e., insecure housing situation and residence status, older respondents, and females) who reported experiencing higher levels of increased discrimination and increases in daily life stressors. There is a need to recognize the detrimental mental health impact of the COVID-19 pandemic on particular refugee and migrant groups and to develop interventions that target their unique needs.

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  • 29. Szelei, Nikolett
    et al.
    Devlieger, Ines
    Verelst, An
    Spaas, Caroline
    Jervelund, Signe Smith
    Primdahl, Nina Langer
    Skovdal, Morten
    Opaas, Marianne
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Osman, Fatumo
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP. School of Health and Welfare, Dalarna University, Sweden.
    Soye, Emma
    Colpin, Hilde
    De Haene, Lucia
    Aalto, Sanni
    Kankaanpää, Reeta
    Peltonen, Kirsi
    Andersen, Arnfinn J.
    Hilden, Per Kristian
    Watters, Charles
    Derluyn, Ilse
    Migrant Students’ Sense of Belonging and the Covid‐19 Pandemic: Implications for Educational Inclusion2022In: Social Inclusion, E-ISSN 2183-2803, Vol. 10, no 2, p. 172-184Article in journal (Refereed)
    Abstract [en]

    This article investigates school belonging among migrant students and how this changed during the Covid‐19 pandemic.Drawing on quantitative data gathered from 751 migrant students in secondary schools in six European countries (Belgium,Denmark, Finland, Norway, Sweden, and the UK), we examined the impact of Covid‐19 school closures, social support, andpost‐traumatic stress symptoms on changes in school belonging. Linear regression showed a non‐significant decrease inschool belonging, and none of the studied variables had a significant effect on this change in our whole sample. However,sensitivity analysis on a subsample from three countries (Denmark, Finland, and the UK) showed a small but significantnegative effect of increasing post‐traumatic stress symptoms on school belonging during Covid‐19 school closures. Giventhat scholarship on school belonging during Covid‐19 is emergent, this study delineates some key areas for future researchon the relationship between wellbeing, school belonging, and inclusion.

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    fulltext
  • 30.
    Verelst, An
    et al.
    Univ Ghent, Ctr Social Study Migrat & Refugees, Dept Social Work & Social Pedag, Ghent, Belgium..
    Spaas, Caroline
    Univ Leuven, Fac Psychol & Educ Sci, Parenting & Special Educ Res Unit, Leuven, Belgium..
    Pfeiffer, Elisa
    Ulm Univ, Clin Child & Adolescent Psychiat Psychotherapy, Ulm, Germany..
    Devlieger, Ines
    Univ Ghent, Ctr Social Study Migrat & Refugees, Dept Social Work & Social Pedag, Ghent, Belgium..
    Kankaapaa, Reeta
    Tampere Univ, Fac Social Sci Psychol, Tampere, Finland..
    Peltonen, Kirsi
    Univ Turku, Res Ctr Child Psychiat, Turku, Finland..
    Vanska, Mervi
    Tampere Univ, Fac Social Sci Psychol, Tampere, Finland..
    Soye, Emma
    Univ Sussex, Schoot Educ & Social Work, Brighton, E Sussex, England..
    Watters, Charles
    Univ Sussex, Schoot Educ & Social Work, Brighton, E Sussex, England..
    Osman, Fatumo
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Andersen, Arnfinn
    NKVTS, Norwegian Ctr Violence & Traumat Stress Studies, Oslo, Norway..
    Primdahl, Nina Langer
    Univ Copenhagen, Dept Publ Hlth, Copenhagen, Denmark..
    Derluyn, Ilse
    Univ Ghent, Ctr Social Study Migrat & Refugees, Dept Social Work & Social Pedag, Ghent, Belgium..
    Social Determinants of the Mental Health of Young Migrants2022In: EUROPEAN JOURNAL OF HEALTH PSYCHOLOGY, ISSN 2512-8442, Vol. 29, no 1, p. 61-73Article in journal (Refereed)
    Abstract [en]

    Background: Young migrants face particular risks to develop mental health problems. Discrimination and social support impact mental health, yet little is known about the differential impact thereof on mental health in newcomers, non-newcomer migrants, and non-migrants. Aim: This study sheds light on mental health (posttraumatic stress, behavioral problems, hyperactivity, emotional distress, peer relationship problems, prosocial behavior) and the overall well-being of newcomers, non-newcomer migrants, and non-migrants. Furthermore, the impact of social support and discrimination on mental health is investigated. Method: Descriptive analysis and Structural Equation Modelling (SEM) were applied to analyze responses of 2,320 adolescents through self-report questionnaires in Finland, Sweden, and the UK. Results: Newcomers, non-newcomer migrants, and non-migrants have different psychological profiles. While newcomers suffer more from posttraumatic stress disorder (PTSD) and peer problems, non-newcomers and non-migrants report more hyperactivity. Discrimination strongly threatens all mental health dimensions, while support from family serves as a protective factor. Support from friends has a positive impact on PTSD among newcomers. Limitations: As this study has a cross-sectional design, conclusions about causality cannot be drawn. In addition, history of traumatic life events or migration trajectory was lacking, while it may impact mental health. Conclusion: Different mental health profiles of newcomers, non-newcomer migrants, and non-migrants point to the need for a tailored and diversified approach. Discrimination remains a risk factor for mental health, while family support is a protective factor for adolescents. Interventions that foster social support from friends would be especially beneficial for newcomers.

  • 31.
    Vinberg, Maria
    et al.
    Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.;Stockholm Cty Council, Stockholm Hlth Care Serv, Stockholm, Sweden..
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP. Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.;Stockholm Cty Council, Stockholm Hlth Care Serv, Stockholm, Sweden..
    Rosendahl, Ingvar
    Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.;Stockholm Cty Council, Stockholm Hlth Care Serv, Stockholm, Sweden..
    Gambling and gambling problem among elite athletes and their professional coaches: findings from a Swedish total population survey of participants in four sports2020In: International Gambling Studies, ISSN 1445-9795, E-ISSN 1479-4276, Vol. 20, no 2, p. 262-281Article in journal (Refereed)
    Abstract [en]

    This study assessed the following among elite athletes and their coaches in Sweden: (i) prevalence of gambling and 'at risk for gambling problems' (PGSI 3+); and (ii) relations between 'at risk for gambling problems' and attitudes towards gambling, experiences of gambling, and individual and demographic factors. A total of 1438 athletes and 401 coaches, in four sports, completed an online survey. Overall, 2% of female athletes and 13% of male athletes were classified as being 'at risk for gambling problems'. Using an ordinal logistic regression, the results showed associations between 'at risk for gambling problems' and eight of the investigated variables: 'talk about gambling during training', 'coaches positive attitude towards gambling', 'gambling companies encourage gambling', 'I have gambled on own game', 'someone I know has gambled on their own game', 'gambling is important in the family', 'someone in my acquaintance have/had a gambling problem', 'alcohol consumption' among the athletes. Coaches of men's teams had a higher prevalence (7%) than did coaches of women's teams (3%). The findings suggest that the sports clubs should have greater knowledge about gambling problems as well as a communication strategy of their acquired knowledge to their athletes and coaches.

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  • 32.
    Vinberg, Maria
    et al.
    Swedish Gambling Author, Strangnas, Sweden..
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP. Uppsala Univ, Dept Publ Hlth & Caring Sci, Child Hlth & Parenting CHAP, Uppsala, Sweden..
    Rosendahl, Ingvar
    Karolinska Inst, Stockholm Cty Council, Stockholm Hlth Care Serv, Ctr Psychiat Res,Dept Clin Neurosci, Stockholm, Sweden..
    Young male athletes at risk for problem gambling: Findings from a cross-sectional study in Sweden2023In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 64, no 6, p. 766-775Article in journal (Refereed)
    Abstract [en]

    Previous research has shown that male athletes at the elite level in Sweden have a higher proportion of gambling problems than the average male population in the country. However, there is a knowledge gap in the prevalence of gambling problems among young athletes. To address this gap, this study aimed to explore gambling behavior among young athletes and to examine the associations between individual and environmental factors and problem gambling. The cross-sectional survey comprised questions from the Problem Gambling Severity Index and the Alcohol Use Disorders Identification Test, in addition to self-constructed items on individual and environmental factors. The data were derived from a sample of 1,636 students from the National Sports Education Program (NIU) and 816 grassroots athletes of the same age (16-20 years old). The results showed that male athletes had a higher prevalence of problem gambling compared to female athletes, and that a large proportion of male athletes had gambled during school hours. The prevalence of problem gambling was almost zero for women. The prevalence of problem gambling among male athletes over 18 years of age was 9% in NIU athletes and 3.6% in grassroots athletes, while for men under 18 years of age, the prevalence was 4.9% in NIU athletes and 1.3% in grassroots athletes. The study highlights the importance of considering contextual factors such as the school and team environment in preventing problem gambling among young male athletes.

  • 33.
    Warner, Georgina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Durbeej, Natalie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Salari, Raziye
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Fängström, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Lampa, Elin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Baghdasaryan, Zaruhi
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Osman, Fatumo
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Gupta Löfving, Sandra
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Centre for Research and Development, Gävleborg.
    Perez Aronsson, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP.
    Feldman, Inna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Sampaio, Filipa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Ssegonja, Richard
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Lung- allergy- and sleep research.
    Bjärtå, Anna
    Mid Sweden University.
    Rondung, Elisabet
    Mid Sweden University.
    Leiler, Anna
    Mid Sweden University.
    Wasteson, Elisabet
    Mid Sweden University.
    Calam, Rachel
    University of Manchester.
    Oppedal, Brit
    Norwegian Institute for Public Health.
    Keeshin, Brooks
    University of Utah.
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social medicine/CHAP. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Evaluation of the teaching recovery techniques community-based intervention for accompanied refugee children experiencing post-traumatic stress symptoms (Accompanied refugeeS In Sweden Trial; ASsIST): study protocol for a cluster randomised controlled trial2020In: BMJ Open, E-ISSN 2044-6055, Vol. 10, no 7, article id e035459Article in journal (Refereed)
    Abstract [en]

    Background Refugee children have often experienced traumas and are at significant risk of developing mental health problems, such as symptoms of post-traumatic stress disorder (PTSD), depression and anxiety, which can continue for years after resettlement. The Accompanied refugeeS In Sweden Trial (ASsIST) aims to evaluate a community-based intervention, called ‘Teaching Recovery Techniques’ (TRT), for accompanied refugee minors experiencing PTSD symptoms.

    Methods/design A cluster randomised controlled trial will be conducted in which participants will be randomly allocated to one of the two possible arms: the intervention arm (n=113) will be offered the TRT programme and the waitlist-control arm (n=113) will receive services as usual, followed by the TRT programme around 20 weeks later. Outcome data will be collected at three points: pre-intervention (T1), post-intervention (T2; c.8 weeks after randomisation) and follow-up (T3; c.20 weeks after randomisation).

    Ethics and dissemination Ethical approval was granted by the Regional Ethical Review Board in Uppsala (Ref. 2018/382) (24th February 2019). Results will be published in scientific journals.

    Trial registration details ISRCTN17754931. Prospectively registered on 4th June 2019.

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