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  1. Article: A child‐centered health dialogue for the prevention of obesity in child health services in Sweden – A randomized controlled trial including an economic evaluation

    Derwig, Mariette / Tiberg, Irén / Björk, Jonas / Welander Tärneberg, Anna / Hallström, Inger Kristensson

    Obesity science & practice. 2022 Feb., v. 8, no. 1

    2022  

    Abstract: BACKGROUND: Prevention of child obesity is an international public health priority and believed to be effective when started in early childhood. Caregivers often ask for an early and structured response from health professionals when their child is ... ...

    Abstract BACKGROUND: Prevention of child obesity is an international public health priority and believed to be effective when started in early childhood. Caregivers often ask for an early and structured response from health professionals when their child is identified with overweight, yet cost‐effective interventions for children aged 2–6 years and their caregivers in Child Health Services are lacking. OBJECTIVES: To evaluate the effects and cost‐effectiveness of a child‐centered health dialogue in the Child Health Services in Sweden on 4‐year‐old children with normal weight and overweight. METHODS: Thirty‐seven Child Health Centers were randomly assigned to deliver intervention or usual care. The primary outcome was zBMI‐change. RESULTS: A total of 4598 children with normal weight (zBMI: 0.1 [SD = 0.6] and 490 children with overweight (zBMI: 1.6 [SD = 0.3]) (mean age: 4.1 years [SD = 0.1]; 49% females) were included. At follow‐up, at a mean age of 5.1 years [SD = 0.1], there was no intervention effect on zBMI‐change for children with normal weight. Children with overweight in the control group increased zBMI by 0.01 ± 0.50, while children in the intervention group decreased zBMI by 0.08 ± 0.52. The intervention effect on zBMI‐change for children with overweight was –0.11, with a 95% confidence interval of –0.24 to 0.01 (p = 0.07). The estimated additional costs of the Child‐Centered Health Dialogue for children with overweight were 167 euros per child with overweight and the incremental cost‐effectiveness ratio was 183 euros per 0.1 zBMI unit prevented. CONCLUSIONS: This low‐intensive multicomponent child‐centered intervention for the primary prevention of child obesity did not show statistical significant effects on zBMI, but is suggested to be cost‐effective with the potential to be implemented universally in the Child Health Services. Future studies should investigate the impact of socio‐economic factors in universally implemented obesity prevention programs.
    Keywords caregivers ; child health ; childhood ; childhood obesity ; children ; confidence interval ; cost effectiveness ; economic evaluation ; public health ; randomized clinical trials ; Sweden
    Language English
    Dates of publication 2022-02
    Size p. 77-90.
    Publishing place John Wiley & Sons, Ltd
    Document type Article
    Note JOURNAL ARTICLE
    ZDB-ID 2836381-4
    ISSN 2055-2238
    ISSN 2055-2238
    DOI 10.1002/osp4.547
    Database NAL-Catalogue (AGRICOLA)

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  2. Book ; Article ; Online: Building Bridges

    Persson, Maria / Soegaard, Christian / Welander Tärneberg, Anna

    The Effect of Major Infrastructure Development on Trade

    2022  

    Abstract: We provide evidence of a positive effect of major infrastructure development on international trade, using the opening of the fixed link between Denmark and Sweden in 2000 (The Oresund Bridge) as a quasi-natural experiment. Our Synthetic Control Method ( ... ...

    Abstract We provide evidence of a positive effect of major infrastructure development on international trade, using the opening of the fixed link between Denmark and Sweden in 2000 (The Oresund Bridge) as a quasi-natural experiment. Our Synthetic Control Method (SCM) constructs a counterfactual Danish-Swedish trade relationship, which represents bilateral trade in the absence of the bridge. Evaluating actual trade against its synthetic counterpart for the period 2001-2008 shows that Danish-Swedish trade was 24.6% larger than it would have been in the absence of the bridge using our preferred specification. The result is robust to standard sensitivity checks. We supplement our analysis with a standard Difference-in-differences (DiD) estimator, which uses fixed effects. The DiD estimator yields a slightly larger trade effect of 26.7%, and is robust to a number of sensitivity analyses, including estimation at the product level. Both our SCM and DiD point to the trade-boosting effects being gradual.
    Keywords ddc:330 ; F14 ; F15 ; Fixed link ; bridge ; tunnel ; transport infrastructure ; trade ; Synthetic Control Method ; Difference-in-differences
    Subject code 381
    Language English
    Publisher Lund: Lund University, School of Economics and Management, Department of Economics
    Publishing country de
    Document type Book ; Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: eHealth literacy and socioeconomic and demographic characteristics of parents of children needing paediatric surgery in Sweden.

    Kristjánsdóttir, Ólöf / Welander Tärneberg, Anna / Stenström, Pernilla / Castor, Charlotte / Kristensson Hallström, Inger

    Nursing open

    2022  Volume 10, Issue 2, Page(s) 509–524

    Abstract: Aim: The aim of the study was to describe different eHealth literacy domains among parents of children needing paediatric surgery in Sweden, and the correlation between these eHealth literacy domains and parents' socioeconomic factors and demographic ... ...

    Abstract Aim: The aim of the study was to describe different eHealth literacy domains among parents of children needing paediatric surgery in Sweden, and the correlation between these eHealth literacy domains and parents' socioeconomic factors and demographic characteristics.
    Design: Descriptive correlational design.
    Method: Thirty-five Swedish-speaking parents participated as a historical control group within an ongoing Swedish clinical trial developing eHealth solutions for families after hospital care; of these, 30 completed the eHealth Literacy Questionnaire and the socioeconomic and demographic questionnaire.
    Results: Of the seven eHealth literacy domains assessed, parents' strengths lay in those pertaining to their own digital competence, control and safety, while their weakness concerned their motivation to engage with digital services, and their ability to access eHealth platforms that work. Overall, parents presented adequate eHealth literacy. Of the five socioeconomic and demographic variables assessed (i.e. monthly wages, education levels, age, gender and residency), monthly wages correlated the strongest, and positively, with the seven eHealth literacy domains.
    MeSH term(s) Humans ; Child ; Sweden ; Health Literacy ; Cross-Sectional Studies ; Parents ; Socioeconomic Factors ; Telemedicine ; Demography
    Language English
    Publishing date 2022-08-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2809556-X
    ISSN 2054-1058 ; 2054-1058
    ISSN (online) 2054-1058
    ISSN 2054-1058
    DOI 10.1002/nop2.1316
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: A child-centered health dialogue for the prevention of obesity in child health services in Sweden - A randomized controlled trial including an economic evaluation.

    Derwig, Mariette / Tiberg, Irén / Björk, Jonas / Welander Tärneberg, Anna / Hallström, Inger Kristensson

    Obesity science & practice

    2021  Volume 8, Issue 1, Page(s) 77–90

    Abstract: Background: Prevention of child obesity is an international public health priority and believed to be effective when started in early childhood. Caregivers often ask for an early and structured response from health professionals when their child is ... ...

    Abstract Background: Prevention of child obesity is an international public health priority and believed to be effective when started in early childhood. Caregivers often ask for an early and structured response from health professionals when their child is identified with overweight, yet cost-effective interventions for children aged 2-6 years and their caregivers in Child Health Services are lacking.
    Objectives: To evaluate the effects and cost-effectiveness of a child-centered health dialogue in the Child Health Services in Sweden on 4-year-old children with normal weight and overweight.
    Methods: Thirty-seven Child Health Centers were randomly assigned to deliver intervention or usual care. The primary outcome was zBMI-change.
    Results: A total of 4598 children with normal weight (zBMI: 0.1 [SD = 0.6] and 490 children with overweight (zBMI: 1.6 [SD = 0.3]) (mean age: 4.1 years [SD = 0.1]; 49% females) were included. At follow-up, at a mean age of 5.1 years [SD = 0.1], there was no intervention effect on zBMI-change for children with normal weight. Children with overweight in the control group increased zBMI by 0.01 ± 0.50, while children in the intervention group decreased zBMI by 0.08 ± 0.52. The intervention effect on zBMI-change for children with overweight was -0.11, with a 95% confidence interval of -0.24 to 0.01 (
    Conclusions: This low-intensive multicomponent child-centered intervention for the primary prevention of child obesity did not show statistical significant effects on zBMI, but is suggested to be cost-effective with the potential to be implemented universally in the Child Health Services. Future studies should investigate the impact of socio-economic factors in universally implemented obesity prevention programs.
    Language English
    Publishing date 2021-08-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2836381-4
    ISSN 2055-2238 ; 2055-2238
    ISSN (online) 2055-2238
    ISSN 2055-2238
    DOI 10.1002/osp4.547
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Health-care quality and information failure: Evidence from Nigeria.

    Evans, David K / Welander Tärneberg, Anna

    Health economics

    2017  Volume 27, Issue 3, Page(s) e90–e93

    Abstract: Low-quality health services are a problem across low- and middle-income countries. Information failure may contribute, as patients may have insufficient knowledge to discern the quality of health services. That decreases the likelihood that patients will ...

    Abstract Low-quality health services are a problem across low- and middle-income countries. Information failure may contribute, as patients may have insufficient knowledge to discern the quality of health services. That decreases the likelihood that patients will sort into higher quality facilities, increasing demand for better health services. This paper presents results from a health survey in Nigeria to investigate whether patients can evaluate health service quality effectively. Specifically, this paper demonstrates that although more than 90% of patients agree with any positive statement about the quality of their local health services, satisfaction is significantly associated with the diagnostic ability of health workers at the facility. Satisfaction is not associated with more superficial characteristics such as infrastructure quality or prescriptions of medicines. This suggests that patients may have sufficient information to discern some of the most important elements of quality, but that alternative measures are crucial for gauging the overall quality of care.
    MeSH term(s) Consumer Health Information/standards ; Health Knowledge, Attitudes, Practice ; Health Services Administration/standards ; Health Surveys ; Humans ; Nigeria ; Patient Satisfaction ; Quality Indicators, Health Care ; Quality of Health Care/standards ; Socioeconomic Factors
    Language English
    Publishing date 2017-10-23
    Publishing country England
    Document type Journal Article
    ZDB-ID 1135838-5
    ISSN 1099-1050 ; 1057-9230
    ISSN (online) 1099-1050
    ISSN 1057-9230
    DOI 10.1002/hec.3611
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Analysis of clinical knowledge, absenteeism and availability of resources for maternal and child health: a cross-sectional quality of care study in 10 African countries.

    Di Giorgio, Laura / Evans, David K / Lindelow, Magnus / Nguyen, Son Nam / Svensson, Jakob / Wane, Waly / Welander Tärneberg, Anna

    BMJ global health

    2020  Volume 5, Issue 12

    Abstract: Objective: Assess the quality of healthcare across African countries based on health providers' clinical knowledge, their clinic attendance and drug availability, with a focus on seven conditions accounting for a large share of child and maternal ... ...

    Abstract Objective: Assess the quality of healthcare across African countries based on health providers' clinical knowledge, their clinic attendance and drug availability, with a focus on seven conditions accounting for a large share of child and maternal mortality in sub-Saharan Africa: malaria, tuberculosis, diarrhoea, pneumonia, diabetes, neonatal asphyxia and postpartum haemorrhage.
    Methods: With nationally representative, cross-sectional data from ten countries in sub-Saharan Africa, collected using clinical vignettes (to assess provider knowledge), unannounced visits (to assess provider absenteeism) and visual inspections of facilities (to assess availability of drugs and equipment), we assess whether health providers are available and have sufficient knowledge and means to diagnose and treat patients suffering from common conditions amenable to primary healthcare. We draw on data from 8061 primary and secondary care facilities in Kenya, Madagascar, Mozambique, Nigeria, Niger, Senegal, Sierra Leone, Tanzania, Togo and Uganda, and 22 746 health workers including doctors, clinical officers, nurses and community health workers. Facilities were selected using a multistage cluster-sampling design to ensure data were representative of rural and urban areas, private and public facilities, and of different facility types. These data were gathered under the Service Delivery Indicators programme.
    Results: Across all conditions and countries, healthcare providers were able to correctly diagnose 64% (95% CI 62% to 65%) of the clinical vignette cases, and in 45% (95% CI 43% to 46%) of the cases, the treatment plan was aligned with the correct diagnosis. For diarrhoea and pneumonia, two common causes of under-5 deaths, 27% (95% CI 25% to 29%) of the providers correctly diagnosed and prescribed the appropriate treatment for both conditions. On average, 70% of health workers were present in the facilities to provide care during facility hours when those workers are scheduled to be on duty. Taken together, we estimate that the likelihood that a facility has at least one staff present with competency and key inputs required to provide child, neonatal and maternity care that meets minimum quality standards is 14%. On average, poor clinical knowledge is a greater constraint in care readiness than drug availability or health workers' absenteeism in the 10 countries. However, we document substantial heterogeneity across countries in the extent to which drug availability and absenteeism matter quantitatively.
    Conclusion: Our findings highlight the need to boost the knowledge of healthcare workers to achieve greater care readiness. Training programmes have shown mixed results, so systems may need to adopt a combination of competency-based preservice and in-service training for healthcare providers (with evaluation to ensure the effectiveness of the training), and hiring practices that ensure the most prepared workers enter the systems. We conclude that in settings where clinical knowledge is poor, improving drug availability or reducing health workers' absenteeism would only modestly increase the average care readiness that meets minimum quality standards.
    MeSH term(s) Absenteeism ; Child ; Child Health ; Child Health Services ; Cross-Sectional Studies ; Female ; Humans ; Infant, Newborn ; Kenya/epidemiology ; Maternal Health Services ; Nigeria ; Pregnancy ; Senegal
    Language English
    Publishing date 2020-12-19
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2059-7908
    ISSN 2059-7908
    DOI 10.1136/bmjgh-2020-003377
    Database MEDical Literature Analysis and Retrieval System OnLINE

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