Background: Childhood represents an important life stage for establishment of physical activity (PA) habits. Parents are assumed to play an important role in influencing children’s PA. Earlier reviews have mainly focused on parental modelling, encouragement, and support for PA, rather than the actual PA levels of parents. Therefore, the purpose of this review was to systematically summarize the evidence on the relationship between parent and child PA.Methods: Papers were identified using electronic databases and manual searches of reference lists. Papers reporting on associations between objectively measured child PA and at least one measure of parental PA were included. The quality of the papers was assessed using a modified version of the ROBINS-I tool. For interpretation of the results across studies, we produced albatross plots for all studies combined and by age-groups, sex of the parents, sex of the child, methodology of assessment of parental PA, and type of PA.Results: Thirty-nine papers were included with sample size of parent-child dyads ranging from 15 to 1267 (mean = 319 dyads, median = 227 dyads). The majority of studies were published from 2008 to 2018 and used accelerometry to assess PA. Most of the studies were classified as having moderate, serious, or critical risk of bias. The albatross plot for all studies combined showed that the clear majority of studies observed a positive relationship between parent and child PA. The plot suggested an average magnitude of correlation across studies to be around 0.13, and the overall impression was that this was fairly similar across child age-groups and gender of parent-child dyads. Studies using objective assessment of parental PA showed stronger relationship between parent and child PA compared with studies using self-report (average magnitude of correlation around 0.16 vs 0.04 respectively). No clear evidence was found for the strength of relationship being dependent on type of PA measure of parent and child (total PA, moderate-to-vigorous PA, steps), however, the relationship for light PA appeared weaker.Conclusion: This systematic review showed that the clear majority of studies observed a weak positive relationship between parent and child PA regardless of age of the child, the gender of the parent-child dyad, and type of PA.Trial registration: Registration in PROSPERO:CRD42019093462.

Introduction: Lolland-Falster consists of two islands in the southern part of Denmark where income is lower and life expectancy is shorter than in the general Danish population. It is a mixed rural-provincial area with approximately 100,000 inhabitants. The Lolland-Falster Health Study was initiated to gain knowledge on the determinants of health in this disadvantaged area. Methods: The study is a household-based prospective cohort study including people of all ages. The entire household of randomly selected inhabitants is allocated either to an invited group or to an uninvited, non-contacted control group. The data collection encompasses questionnaires, physical examination and biological samples, i.e. blood and urine for same-day analysis and biobank storage, and saliva and faeces also for biobank storage. The civil registration number links collected data for each individual, family and household, with information in Danish registers. The data collection started in February 2016 and is estimated to end by 2019 after the enrolment of 20,000 people. Analysis: A number of in-depth sub-studies are planned. Emphasis will be given to analysis of intra- and inter-family variations in health determinants, genetics, lifestyle and health status. Ethics: Region Zealand’s Ethical Committee on Health Research (SJ-421) and the Danish Data Protection Agency (REG-24-2015) approved the study. Trial registration: Clinicaltrials.gov (NCT02482896). Strength and limitations of this study: The strength of this study is that Lolland-Falster Health Study is a useful scientific resource for investigating cross-sectional difference and time trends within and between individuals, families and households. LOFUS adds diversity to the previously collected Danish population studies in urbanized areas. The limitation is that data collection is expensive. Conclusions: LOFUS will contribute to the knowledge on health in disadvantaged, rural-provincial areas.

Background.Previous research has found that sense of coherence is significantly related to aspects of health, but studies on nurse students with a salutogenic approach are limited.Objectives.To investigate (1) if nurse students’ experience of stress differs among clinical practice in nursing homes and medical/surgical wards. (2) Whether sense of coherence and stress are associated with quality of life. (3) If sense of coherence acts as a moderator in the relationship between stress and quality of life.Participants.Data were collected from 227 nurse students between January and April 2014.Methods.Questionnaires measuring stress, sense of coherence and quality of life were completed after a period of clinical practice. Linear regression analyses were used to measure associations between stress, and sense of coherence respectively, and quality of life.Results.The results showed that 33.92% of the students experienced moderate or high levels of stress, and there was significantly more stress in hospital wards compared to nursing homes (p= 0.027). Sense of coherence was positively associated with quality of life in the simple and multiple regression analyses (p< 0.01). Stress was negatively associated with quality of life in the simple regression analysis (p< 0.01), but not in the multiple analyses when sense of coherence was included. However, when we included an interaction term, stress was no longer associated with quality of life and sense of coherence appeared to be a significant moderator in the relationship between stress and quality of life (p= 0.015). Thus, a negative association was seen among students with the lowest levels of sense of coherence.Conclusion.These findings suggest that sense of coherence could be seen as a resource that nurse educators can build upon when supporting students in coping with stress.

In composing multi-thematic questionnaires for the Lolland-Falster Health Study (LOFUS), we faced a range of challenges, for which we found limited guidance in the literature. LOFUS is a household-based population study covering multiple medical and social research areas and targeting the mixed rural-provincial population of 103,000 persons on the Danish islands Lolland and Falster. Households were randomly selected for invitation. In this paper, we describe and discuss challenges in developing the questionnaires related to stakeholders, content of the questionnaire, and the process itself. The development process was characterised by loops of learning and can be described as an iterative and incremental process. We propose recommendations to researchers and administrators involved in similar development processes, including awareness of the non-linearity and complexity of the process, a need for negotiations and navigation among multiple stakeholders, and acknowledgement of pragmatism as an inherent part of decisions made in the process.

Aim: The Lolland-Falster Health Study (LOFUS) is an ongoing prospective cohort study at Lolland-Falster, one of the most socio-economically disadvantaged areas of Denmark. The aim of this study was to examine the participation rates and socio-economic determinants of participation in LOFUS, approximately halfway through the data collection. Subjects and methods: LOFUS started in 2016 and should include 20,000 participants from the total of 103,000 inhabitants of Lolland-Falster by the end of 2019. For the participation analyses, we used data on the 36,883 subjects invited between January 2016 and November 2018. For the analyses of determinants of participation, we used data on the 24,283 adults (aged ≥ 18 years) invited between January 2016 and June 2018, for whom we extracted data on personal income, employment, education, marital status, citizenship, and household type from Danish registers. We used logistic regression to estimate associations between socio-economic factors and participation, adjusting for age and gender. Results: 34.1% of invited subjects participated (men: 31.9%, women: 36.4%), with the highest rate in women aged 60–69 years (47.5%) and the lowest in women aged ≥ 90 years (7.3%). Odds ratios for participation increased with income, education level, and employment status, and among married persons, Danish citizens, middle-aged persons (aged 50–69 years), and women. Conclusion: Subjects with lower socio-economic status were underrepresented halfway through the LOFUS data collection, in line with other cohort studies.

It is unknown how changes in physical activity may affect changes in quality of life (QoL) outcomes during lifestyle interventions for severely obese adults. The purpose of this study was to examine associations in the patterns of change between objectively assessed physical activity as the independent variable and physical, mental, and obesity-specific QoL and life satisfaction as the dependent variables during a two-year lifestyle intervention. Forty-nine severely obese adults (37 women;43.6±9.4years; body mass index42.1±6.0 kg/m²) participated in the study. Assessments were conducted four times using Medical Outcomes Study Short-Form 36 Health Survey (SF-36), Obesity-Related Problems (OP) scale, a single item on life satisfaction, and accelerometers. The physical component summary (PCS) score and the mental component summary (MCS) score were used as SF-36 outcomes. Associations were determined using linear regression analyses and reported as standardized coefficients (stand. coeff.). Change in physical activity was independently associated with change in PCS (stand. coeff. = 0.35,P=.033), MCS (stand. coeff. = 0.51,P=.001), OP (stand. coeff. = −0.31, P=.018), and life satisfaction (stand. coeff. = 0.39,P=.004) after adjustment for gender, age, and change in body mass index.