There is a global need for sustainable interventions that increase physical activity among children, and active school transportation (AST) can promote physical activity among schoolchildren. Therefore, an intervention based on gamification, empowerment, and social cognitive theory was initiated in 2016 to promote AST. The aim of this study was to follow up on participants’ experiences one and two years after the AST intervention was initiated. Data were collected through focus groups and individual interviews which were analyzed using qualitative content analysis. Thirty-one pupils (2017), and forty pupils (2018) aged 9–10 years, two teachers (2017, 2018) and one principal (2018) participated in the study. The result is presented as one main theme; “Unity for an active community-An intervention towards making the active choice the easy choice” and three sub-themes; “Well begun is half done-Engagement sparks motivation”, “It takes two to tango-Keep moving with gamifications and togetherness” and “Jumping on the bandwagon–From project to everyday use.” The results show that the concept of the intervention was attractive to re-use and that it created a habit to use AST among the children. Interventions to promote AST can benefit from the use of engagement, togetherness, and gamification.

Background: Over the last decades, the prevalence of AST has decreased significantly. Barriers to active school transport (AST) have been extensively examined in the literature, while psychosocial factors that facilitate AST have received less attention. To our best knowledge, there are currently no reviews on this subject. Therefore, the objective of this review was to scope the literature and identify published research about psychosocial factors related to AST. Methods: Systematic searches conducted in PubMed, Web of Science, TRID, Scopus, and ERIC resulted in a total of 1933 publications, and 77 of them were considered eligible for this review. Results: The results of the included articles were categorised into four psychosocial factors: confidence in ability, attitudes, social support, and social norms, which were all generally positively related to AST, with a few exceptions. Conclusion: The findings of this review indicate that these psychosocial factors may be important to consider when developing interventions and highlight that both children and parents should be involved in the process. This knowledge can serve as a valuable guide for developing interventions to promote AST. However, the evidence base supporting these psychosocial factors requires further investigation to fully understand how and when to incorporate them to maximise AST efficacy.

Background: Proactive end-of-life (EoL) conversations can help individuals, their significant others, and health care professionals be better prepared to confront dying and future EoL decision-making. Talking about EoL issues may be unfamiliar and difficult; tools are increasingly used to support such conversations. While using digital tools presents many advantages, the development processes of such are seldom robustly reported. The project outlined here has the overall aim of further developing and investigating promotion of early, proactive EoL conversations by cocreating and testing, together with potential community-based end users, a digital version of an existing tool, the DöBra cards. Objective: The aim of this paper is to outline the protocol for a funded participatory action research project, cocreating a digital tool for proactive EoL conversations, as well as reporting initial steps taken in the project. Methods: Project design is overall inspired by participatory action research and contains 2 work packages (WPs). WP A encompasses the iterative cocreation process of adapting the initial prototype into a relevant digital tool for the public in Sweden. WP B explores if and how the digital tool can support potential end users and significant others in proactive conversations about future EoL values and preferences. Digital tool development is inspired by a process map and will be conducted in collaborative groups. Data collection for both WPs includes repeated interviews with cocreation partners and meeting documentation. Data from field testing of the tool will encompass audiotaped think-aloud exercises, researchers’ observations, usability data, and event log data. Analyses will be qualitative, quantitative, and to some extent mixed methods, and may include inductive thematic analyses, longitudinal qualitative analysis, and descriptive and inferential analyses. Results: Following funding and project start in January 2024, ethical approval was granted by the Swedish Ethical Review Authority. A stepwise recruitment strategy focusing on heterogeneity yielded an advisory group with 16 members from 13 organizations, representing broad segments of society despite some drop-off. The cocreation process, together with the advisory group, has produced a pilot version of the digital tool, which is currently being field tested. Since May 2025, 42 testers have been recruited. Data analysis is pending. The digital tool will be publicly launched in 2026, readily available, free of charge, and for anyone to use. Results will be disseminated at scientific conferences, in peer-reviewed journals, and through popular science communication. Conclusions: The cocreative process outlined in this protocol has the potential to develop a digital tool for proactive EoL conversations that is broadly used in the public by varied end users. The digital tool can thus reach new groups in society, potentially highlighting death as a natural part of life and reinforcing normalization of EoL conversations.

Background: The transition of social health care tools from paper-based to web-based formats is increasingly common in social and health care settings. While digital delivery may improve accessibility, flexibility, and scalability, such transitions require careful adaptation of content, design, and workflows. However, evidence on how these transitions are carried out in practice, and which challenges and strategies are involved, remains fragmented. Objective: This scoping review aimed to map how social health care tools have transitioned from paper-based to web-based formats and to synthesize evidence on tool characteristics and target groups, adaptations made during the transition, strategies and methodologies used, and reported challenges and solutions. Methods: A scoping review was conducted following the Arksey and O’Malley framework. Systematic searches were performed in PubMed, PsycINFO, Scopus, and Web of Science to identify English-language empirical studies describing the transition of social health care tools from paper-based to web-based formats. Social health care tools were defined as technologies supporting communication, reflection, or informed decision-making among patients, family caregivers, and/or health care professionals. Two reviewers independently screened studies and extracted data using a standardized form. Targeted gray literature searches were conducted to supplement missing information about the included tools. Findings were synthesized narratively and presented in tables. Results: Eleven tools were included. Most were delivered as web-based platforms (n=8), with additional tools delivered as mobile apps (n=2) or in a game-based format (n=1). The tools targeted diverse populations, including people with chronic or life-limiting conditions, family caregivers, adolescents, parents, pregnant women, and health care professionals. Reported reasons for transitioning to digital formats included improving accessibility and reach (n=7), enhancing user engagement through interactive features (n=5), and increasing efficiency or scalability (n=3). Across tools, core content was largely retained, while adaptations mainly focused on format and delivery, such as multimedia elements, interactive modules, tailored feedback, and usability improvements. User-centered and participatory design approaches were commonly reported, sometimes combined with iterative or agile development methods. Common challenges included usability issues, low engagement, technical integration difficulties, administrative delays, and resource constraints, with solutions focusing on iterative redesign, clearer instructions, increased interactivity, and hybrid paper-digital approaches. Conclusions: This scoping review examines the process of transitioning social health care tools from paper-based to web-based formats, rather than focusing solely on effectiveness outcomes. It synthesizes how adaptations are made, which strategies are used, and which challenges arise during digitalization. The findings identify common adaptation patterns and gaps in reporting, particularly regarding target group–specific design and equity considerations. These insights may support developers, researchers, and policymakers in planning more usable, inclusive, and context-sensitive digital transitions in social and health care settings.