Although the health benefits of physical activity are well documented, a large proportion of the population remains less active than recommended by current guidelines. Commercial fitness centers provide an opportunity to perform physical activity and exercise, but there has been little research focusing on ordinary members at commercial fitness centers. The aim of this study was therefore to explore what long-term members (> 2 years) wanted to achieve with their membership and to identify important factors that influenced them to use the fitness center as a means for physical activity. This was a qualitative study with 21 semi-structured individual interviews of adult long-term fitness center members in Trondheim, a city in Central Norway with approximately 190,000 inhabitants. The participants had been continuous fitness center members for more than two years and were asked about their experiences using a fitness center and what they wanted to achieve with the membership. The data was analyzed thematically with the method of systematic text condensation. The results were categorized into three main themes: “Health benefits and physical appearance”; “Accessible, safe, and comfortable to use”; and “Variety, flexibility, and support.” The participants stated that they wanted to achieve health benefits, but they also talked about physical appearance. The fitness center was mainly described as easily accessible and a comfortable place for physical activity. Some female participants emphasized the feeling of safety compared to outdoor activity. Variation in activities, making commitments, and getting support from staff and other members were factors contributing to use of the fitness center for physical activity. Achieving desired health benefits and improving physical appearance were the main drivers for long-term members’ use of the fitness center. The fitness center was preferred due to the comfort of the facilities and the possibility to commit to specific exercise times and activities.

To investigate the effects after twelve months related to patient activation and a range of secondary outcomes on persons with chronic pain of a chronic pain self-management course compared to a low-impact outdoor physical activity, delivered in an easily accessible healthcare service in public primary care. An open, pragmatic, parallel group randomised controlled trial was conducted. The intervention group was offered a group-based chronic pain self-management course with 2.5-h weekly sessions for a period of six weeks comprising education that included cognitive and behavioural strategies for pain management, movement exercises, group discussions and sharing of experiences among participants. The control group was offered a drop-in, low-impact, outdoor physical activity in groups in one-hour weekly sessions that included walking and simple strength exercises for a period of six weeks. The primary outcome was patient activation assessed using the Patient Activation Measure (PAM-13). Secondary outcomes included assessments of pain, anxiety and depression, pain self-efficacy, sense of coherence, health-related quality of life, well-being and the 30-s Chair to Stand Test. Analyses were performed using a linear mixed model. After twelve months, there were no statistically significant differences between the intervention group (n = 60) and the control group (n = 61) for the primary or the secondary outcomes. The estimated mean difference between the groups for the primary outcome PAM was 4.0 (CI 95% -0.6 to 8.6, p = 0.085). Within both of the groups, there were statistically significant improvements in pain experienced during the previous week, the global self-rated health measure and the 30-s Chair to Stand Test. No long-term effect of the chronic pain self-management course was found in comparison with a low-impact physical activity intervention for the primary outcome patient activation or for any secondary outcome. ClinicalTrials.gov: NCT02531282 . Registered on August 212,015

Aim: The POINT project aims to provide evidence to optimise chronic pain management, prevent adverse consequences of opioids, and improve chronic pain patients’ pain relief, functional capacity, and quality of life. We describe the outline of the project and its work packages. More specifically, we describe a cohort of persons with chronic pain and a cohort of long-term opioid users identified from a national registry linkage. Data Sources: The project utilises data from nationwide healthcare and population registers in Norway. Using the Norwegian Prescription Database, we identified a cohort of persons who have been dispensed drugs reimbursed for chronic pain and a cohort of persons who used opioids long term from 2010 to 2019. Data from the Norwegian Registry for Primary Health Care and the Norwegian Patient Registry (2008– 2019), Cancer Registry (1990– 2018) Cause of Death Registry (2010– 2019) and demographic and socioeconomic registers from Statistics Norway (2010– 2019) were linked to the cohorts. Study Population: There were 568,869 participants with chronic pain. Sixty-three percent of the cohort was women, and the mean age was 57.1 years. There were 336,712 long-term opioid users (58.6% women; 60.9 years). In chronic pain and long-term opioid user cohorts, the most frequent musculoskeletal diagnosis was back pain diagnosed in primary care (27.6% and 30.7%). Psychiatric diagnoses were also common. Main Variables: Upcoming studies will utilise psychiatric and somatic diagnoses from the patient registers, drug use from the prescription register, causes of death, demographics, and socioeconomic status (eg, education, income, workability, immigrant status) as exposures or outcomes. Conclusion and Future Plans: The two cohorts have numerous pain-related diagnoses, especially in the musculoskeletal system, and noticeably frequent somatic and psychiatric morbidity. The POINT project also includes later work packages that explore prescriber and patient perspectives around safe and effective treatment of chronic pain.

Objectives To investigate the effects on persons with chronic pain after 3 months of a group-based chronic pain self-management course compared with a drop-in, low-impact outdoor physical group activity on patient activation and a range of secondary outcomes. Design An open, pragmatic, parallel group randomised controlled trial. Analyses were performed using a two-level linear mixed model. Setting An easily accessible healthcare service provided by Norwegian public primary healthcare. Participants A total of 121 participants with self-reported chronic pain for 3 months or more were randomised with 60 participants placed in the intervention group and 61 placed in the control group (mean age 53 years, 88% women, 63% pain for 10 years or more). Interventions The intervention group was offered a group-based chronic pain self-management course with 2.5-hour weekly sessions for a period of 6 weeks. The sessions consisted of education, movement exercises and emphasised group discussions. The control group was offered a low-impact outdoor group physical activity in 1-hour weekly sessions that consisted of walking and simple strength exercises for a period of 6 weeks. Main outcomes The primary outcome was patient activation assessed using the Patient Activation Measure. Secondary outcomes measured included assessments of pain, anxiety and depression, pain self-efficacy, sense of coherence, health-related quality of life, well-being and the 30 s chair to stand test. Results There was no effect after 3 months of the group-based chronic pain self-management course compared with the control group for the primary outcome, patient activation (estimated mean difference: −0.5, 95% CI –4.8 to 3.7, p=0.802). Conclusions There was no support for the self-management course having a better effect after 3 months than a low-impact outdoor physical activity offered the control group. Trial registration number NCT02531282; Results.

Objectives To explore factors perceived as positive or negative among young people with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) in relation to school and everyday life. Design A qualitative study with semistructured individual interviews performed at the local hospital or at the informants’ homes between September 2017 and January 2018, with an additional telephone interview to collect data on experiences from the COVID-19 pandemic, conducted in September 2020. Data were analysed using a grounded theory approach. Setting The informants were recruited from two university hospitals that offer interdisciplinary assessments of young people with CFS/ME from various parts of Norway. Participants Five males and 13 females aged 13–21 years with CFS/ME diagnosed 3–56 months prior to the interviews participated. Results The informants were concerned about a lack of educational adaptations and missed social life at school. Educational and social adaptations could improve schooling and health among young people with CFS/ME. Negative experiences were related to a lack of knowledge about CFS/ME among school personnel and young people’s difficulties to limit activities. Online teaching as experienced during the COVID-19 pandemic was described as positive both for education and social life. Conclusions Young people with CFS/ME can benefit from better educational adaptations and increased social interaction with peers. From the participants’ view, factors that limit learning and socialisation include a lack of knowledge about CFS/ME among teachers and school personnel, expectations from teachers of doing more than they could manage at school, feeling alone coping with the disease and not recognising their own limitations regarding what they are able to do. Suggested factors perceived to enhance learning and socialisation were a better understanding of the disease among school personnel and peers, suitable educational adaptations and being able to socialise with peers.

Background Knowledge on the relationship between fitness center use and long-term members' subsequent goal achievement is limited. Therefore, the aim was to investigate the prospective association between the use of fitness centers during 18 months and subsequent self-reported goal achievement among long-term members. Methods This was a registry- and survey-based longitudinal study of 2851 people who had been members at a Norwegian fitness center chain for more than two years. Fitness center use from December 2016 to June 2018 was obtained from registry data. Subsequent goal achievement was measured in a survey in June 2018, assessed by a 1-100 visual analogue scale, and a score between 0 and 50 was defined as low goal achievement. Results Visiting the fitness center frequently and regularly, and having frequent group activity bookings were associated with higher subsequent self-reported goal achievement. Participants with fewest visits (1-57 days) during 18 months were more likely to report low goal achievement than participants with most visits (118-543 days) (OR = 8.5; 95% CI 6.3-11.4). Fitness trainer bookings was not clearly associated with subsequent goal achievement. Conclusions Frequent and regular long-term fitness center use were associated with higher subsequent self-reported goal achievement.