his.sePublications
Change search
Link to record
Permanent link

Direct link
BETA
Alternative names
Publications (10 of 39) Show all publications
Airaksinen, J., Pentti, J., Suominen, S., Vahtera, J. & Kivimäki, M. (2020). An Example of How Immortal Time Bias Can Reverse the Results of an Observational Study [Letter to the editor]. Epidemiology, 31(2), e19-e20
Open this publication in new window or tab >>An Example of How Immortal Time Bias Can Reverse the Results of an Observational Study
Show others...
2020 (English)In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 31, no 2, p. e19-e20Article in journal, Letter (Refereed) Published
Place, publisher, year, edition, pages
Wolters Kluwer, 2020
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Individual and Society VIDSOC
Identifiers
urn:nbn:se:his:diva-18205 (URN)10.1097/EDE.0000000000001103 (DOI)000532258500006 ()31567749 (PubMedID)2-s2.0-85078869541 (Scopus ID)
Note

Export Date: 17 February 2020; Article

Available from: 2020-02-17 Created: 2020-02-17 Last updated: 2020-05-29Bibliographically approved
Kivimäki, M., Batty, G. D., Pentti, J., Shipley, M. J., Sipilä, P. N., Nyberg, S. T., . . . Vahtera, J. (2020). Association between socioeconomic status and the development of mental and physical health conditions in adulthood: a multi-cohort study. The Lancet Public Health, 5(3), e140-e149
Open this publication in new window or tab >>Association between socioeconomic status and the development of mental and physical health conditions in adulthood: a multi-cohort study
Show others...
2020 (English)In: The Lancet Public Health, ISSN 2468-2667, Vol. 5, no 3, p. e140-e149Article in journal (Refereed) Published
Abstract [en]

Background: Socioeconomic disadvantage is a risk factor for many diseases. We characterised cascades of these conditions by using a data-driven approach to examine the association between socioeconomic status and temporal sequences in the development of 56 common diseases and health conditions. Methods: In this multi-cohort study, we used data from two Finnish prospective cohort studies: the Health and Social Support study and the Finnish Public Sector study. Our pooled prospective primary analysis data comprised 109 246 Finnish adults aged 17–77 years at study entry. We captured socioeconomic status using area deprivation and education at baseline (1998–2013). Participants were followed up for health conditions diagnosed according to the WHO International Classification of Diseases until 2016 using linkage to national health records. We tested the generalisability of our findings with an independent UK cohort study—the Whitehall II study (9838 people, baseline in 1997, follow-up to 2017)—using a further socioeconomic status indicator, occupational position. Findings: During 1 110 831 person-years at risk, we recorded 245 573 hospitalisations in the Finnish cohorts; the corresponding numbers in the UK study were 60 946 hospitalisations in 186 572 person-years. Across the three socioeconomic position indicators and after adjustment for lifestyle factors, compared with more advantaged groups, low socioeconomic status was associated with increased risk for 18 (32·1%) of the 56 conditions. 16 diseases formed a cascade of inter-related health conditions with a hazard ratio greater than 5. This sequence began with psychiatric disorders, substance abuse, and self-harm, which were associated with later liver and renal diseases, ischaemic heart disease, cerebral infarction, chronic obstructive bronchitis, lung cancer, and dementia. Interpretation: Our findings highlight the importance of mental health and behavioural problems in setting in motion the development of a range of socioeconomically patterned physical illnesses. Policy and health-care practice addressing psychological health issues in social context and early in the life course could be effective strategies for reducing health inequalities. Funding: UK Medical Research Council, US National Institute on Aging, NordForsk, British Heart Foundation, Academy of Finland, and Helsinki Institute of Life Science.

Place, publisher, year, edition, pages
Elsevier, 2020
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Individual and Society VIDSOC
Identifiers
urn:nbn:se:his:diva-18290 (URN)10.1016/S2468-2667(19)30248-8 (DOI)000518417000009 ()32007134 (PubMedID)2-s2.0-85079835161 (Scopus ID)
Available from: 2020-03-06 Created: 2020-03-06 Last updated: 2020-04-22Bibliographically approved
Nyberg, S. T., Singh-Manoux, A., Pentti, J., Madsen, I. E. H., Sabia, S., Alfredsson, L., . . . Kivimäki, M. (2020). Association of Healthy Lifestyle with Years Lived without Major Chronic Diseases. JAMA Internal Medicine, 180(5), 760-768
Open this publication in new window or tab >>Association of Healthy Lifestyle with Years Lived without Major Chronic Diseases
Show others...
2020 (English)In: JAMA Internal Medicine, ISSN 2168-6106, E-ISSN 2168-6114, Vol. 180, no 5, p. 760-768Article in journal (Refereed) Published
Abstract [en]

Importance: It is well established that selected lifestyle factors are individually associated with lower risk of chronic diseases, but how combinations of these factors are associated with disease-free life-years is unknown. Objective: To estimate the association between healthy lifestyle and the number of disease-free life-years. Design, Setting, and Participants: A prospective multicohort study, including 12 European studies as part of the Individual-Participant-Data Meta-analysis in Working Populations Consortium, was performed. Participants included 116043 people free of major noncommunicable disease at baseline from August 7, 1991, to May 31, 2006. Data analysis was conducted from May 22, 2018, to January 21, 2020. Exposures: Four baseline lifestyle factors (smoking, body mass index, physical activity, and alcohol consumption) were each allocated a score based on risk status: Optimal (2 points), intermediate (1 point), or poor (0 points) resulting in an aggregated lifestyle score ranging from 0 (worst) to 8 (best). Sixteen lifestyle profiles were constructed from combinations of these risk factors. Main Outcomes and Measures: The number of years between ages 40 and 75 years without chronic disease, including type 2 diabetes, coronary heart disease, stroke, cancer, asthma, and chronic obstructive pulmonary disease. Results: Of the 116043 people included in the analysis, the mean (SD) age was 43.7 (10.1) years and 70911 were women (61.1%). During 1.45 million person-years at risk (mean follow-up, 12.5 years; range, 4.9-18.6 years), 17383 participants developed at least 1 chronic disease. There was a linear association between overall healthy lifestyle score and the number of disease-free years, such that a 1-point improvement in the score was associated with an increase of 0.96 (95% CI, 0.83-1.08) disease-free years in men and 0.89 (95% CI, 0.75-1.02) years in women. Comparing the best lifestyle score with the worst lifestyle score was associated with 9.9 (95% CI 6.7-13.1) additional years without chronic diseases in men and 9.4 (95% CI 5.4-13.3) additional years in women (P <.001 for dose-response). All of the 4 lifestyle profiles that were associated with the highest number of disease-free years included a body-mass index less than 25 (calculated as weight in kilograms divided by height in meters squared) and at least 2 of the following factors: Never smoking, physical activity, and moderate alcohol consumption. Participants with 1 of these lifestyle profiles reached age 70.3 (95% CI, 69.9-70.8) to 71.4 (95% CI, 70.9-72.0) years disease free depending on the profile and sex. Conclusions and Relevance: In this multicohort analysis, various healthy lifestyle profiles appeared to be associated with gains in life-years without major chronic diseases. 

Place, publisher, year, edition, pages
American Medical Association, 2020
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Individual and Society VIDSOC
Identifiers
urn:nbn:se:his:diva-18404 (URN)10.1001/jamainternmed.2020.0618 (DOI)32250383 (PubMedID)2-s2.0-85083251732 (Scopus ID)
Available from: 2020-04-23 Created: 2020-04-23 Last updated: 2020-05-20Bibliographically approved
Simonsen, N., Lahti, A., Suominen, S., Välimaa, R., Tynjälä, J., Roos, E. & Kannas, L. (2020). Empowerment-enabling home and school environments and self-rated health among Finnish adolescents. Health Promotion International, 35(1), 82-92
Open this publication in new window or tab >>Empowerment-enabling home and school environments and self-rated health among Finnish adolescents
Show others...
2020 (English)In: Health Promotion International, ISSN 0957-4824, E-ISSN 1460-2245, Vol. 35, no 1, p. 82-92Article in journal (Refereed) Published
Abstract [en]

Perceived health during adolescence has not only immediate consequences for individuals and for society, but also long-term. We need to understand better the health development in this period of the lifespan. Empowerment may be one pathway through which social factors and conditions translate into health effects. This study aimed to examine whether empowerment-enabling home and school environments are associated with self-rated health among adolescents, and whether the associations differ between genders, age or majority/minority language groups. Anonymous questionnaire data from respondents aged 11, 13 and 15 years were obtained from the Health Behaviour in School-aged Children study, conducted in Finland in 2014 in Finnish- and Swedish-speaking schools (n = 5925/1877). The proportion rating their health as excellent varied between 33.6 (11-year-olds) and 23.1% (15-year-olds), boys rating their health as excellent more often than girls in all age groups. Findings showed that indicators of both empowerment-enabling home and school environments were independently and positively related to adolescents' self-rated health. Whereas a respectful, accepting, kind and helpful attitude among classmates and a good home atmosphere were quite consistently associated with excellent health, there were gender and age differences with concern to the other empowerment-enabling indicators. Moreover, there were gender-, age- and language-related differences regarding adolescents' perceptions of how empowerment enabling their environments were. Home and school environments that create opportunities through encouragement and care, and through strengthening feelings of being secure, accepted and respected are potentially empowerment enabling. This study suggests that such environmental qualities are important for the perceived health of young people. 

Place, publisher, year, edition, pages
Oxford University Press, 2020
Keywords
adolescents, empowerment-enabling environment, family, school, self-rated health, adolescent, anonymised data, article, atmosphere, child, empowerment, female, Finland, Finn (citizen), gender, health behavior, human, human experiment, language, major clinical study, male, perception, respect, school child, speech
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Individual and Society VIDSOC
Identifiers
urn:nbn:se:his:diva-18163 (URN)10.1093/heapro/day104 (DOI)30590462 (PubMedID)2-s2.0-85077702101 (Scopus ID)
Available from: 2020-01-24 Created: 2020-01-24 Last updated: 2020-04-22Bibliographically approved
Volanen, S.-M., Lassander, M., Hankonen, N., Santalahti, P., Hintsanen, M., Simonsen, N., . . . Suominen, S. (2020). Healthy learning mind – Effectiveness of a mindfulness program on mental health compared to a relaxation program and teaching as usual in schools: A cluster-randomised controlled trial. Journal of Affective Disorders, 260, 660-669
Open this publication in new window or tab >>Healthy learning mind – Effectiveness of a mindfulness program on mental health compared to a relaxation program and teaching as usual in schools: A cluster-randomised controlled trial
Show others...
2020 (English)In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 260, p. 660-669Article in journal (Refereed) Published
Abstract [en]

Background: Mindfulness-Based Interventions (MBIs) have shown promising effects on mental health among children and adolescents, but high-quality studies examining the topic are lacking. The present study assessed the effects of MBI on mental health in school-setting in an extensive randomised controlled trial. Methods: Finnish school children and adolescents (N = 3519), aged 12–15 years (6th to 8th graders), from 56 schools were randomized into a 9 week MBI group, and control groups with a relaxation program or teaching as usual. The primary outcomes were resilience, socio-emotional functioning, and depressive symptoms at baseline, at completion of the programs at 9 weeks (T9), and at follow-up at 26 weeks (T26). Results: Overall, mindfulness did not show more beneficial effects on the primary outcomes compared to the controls except for resilience for which a positive intervention effect was found at T9 in all participants (β=1.18, SE 0.57, p = 0.04) as compared to the relaxation group. In addition, in gender and grade related analyses, MBI lowered depressive symptoms in girls at T26 (β=−0.49, SE 0.21, p = 0.02) and improved socio-emotional functioning at T9 (β=−1.37, SE 0.69, p = 0.049) and at T26 (β=−1.71, SE 0.73, p = 0.02) among 7th graders as compared to relaxation. Limitations: The inactive control group was smaller than the intervention and active control groups, reducing statistical power. Conclusions: A short 9-week MBI in school-setting provides slight benefits over a relaxation program and teaching as usual. Future research should investigate whether embedding regular mindfulness-based practice in curriculums could intensify the effects. 

Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
Mental health promotion, Mindfulness, Randomized controlled trial, School-based intervention
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Individual and Society VIDSOC
Identifiers
urn:nbn:se:his:diva-17756 (URN)10.1016/j.jad.2019.08.087 (DOI)000490428300083 ()31546105 (PubMedID)2-s2.0-85072510110 (Scopus ID)
Available from: 2019-10-04 Created: 2019-10-04 Last updated: 2020-01-29Bibliographically approved
El Ansari, W., Salam, A. & Suominen, S. (2020). Is alcohol consumption associated with poor perceived academic performance?: Survey of undergraduates in Finland. International Journal of Environmental Research and Public Health, 17(4), Article ID 1369.
Open this publication in new window or tab >>Is alcohol consumption associated with poor perceived academic performance?: Survey of undergraduates in Finland
2020 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 4, article id 1369Article in journal (Refereed) Published
Abstract [en]

The relationship between academic performance and alcohol consumption among students remains inconsistent. We assessed this relationship, controlling for sociodemographic characteristics across seven faculties at the University of Turku (1177 undergraduates). An online questionnaire assessed: seven sociodemographic characteristics (age, gender, year/discipline of study, accommodation type, being in intimate relationship, parental education, and income sufficiency); two perceived academic performance (students’ subjective importance of achieving good grades and students’ appraisal of their academic performance compared to peers); and six alcohol consumption behaviors (length of time, amount consumed, frequency, heavy episodic drinking, problem drinking, and possible alcohol dependence). Simple logistic regression assessed relationships between sociodemographic and academic variables with alcohol consumption behaviors; multiple logistic regression assessed the same relationships after controlling for all other variables. Students reported long duration and large amount of drinking (46% and 50%), high frequency of drinking (41%), heavy episodic drinking (66%), problem drinking (29%), and possible alcohol dependence (9%). After controlling, gender was associated with all alcohol consumption behaviors, followed by religiosity (associated with four alcohol behaviors), living situation, marital status, age (each associated with two alcohol behaviors), and parental education and year of study (each associated with one alcohol behavior). Study discipline, income sufficiency, importance of achieving good grades, and academic performance compared to peers were not associated with any alcohol behaviors. Universities need to assess problem drinking and alcohol use disorders among students. Prevention strategies are required to reduce risk. Health promotion efforts could focus on beliefs and expectations about alcohol and target student groups at risk for more efficient and successful efforts. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.

Place, publisher, year, edition, pages
MDPI, 2020
Keywords
Alcohol dependence, Heavy episodic drinking, Problem drinking, Sociodemographic and educational characteristics, University students
National Category
Public Health, Global Health, Social Medicine and Epidemiology Substance Abuse
Research subject
Individual and Society VIDSOC
Identifiers
urn:nbn:se:his:diva-18291 (URN)10.3390/ijerph17041369 (DOI)000522388500245 ()32093287 (PubMedID)2-s2.0-85079892417 (Scopus ID)
Available from: 2020-03-06 Created: 2020-03-06 Last updated: 2020-04-23Bibliographically approved
Heikkilä, K., Pentti, J., Madsen, I. E. H., Lallukka, T., Virtanen, M., Alfredsson, L., . . . Kivimäki, M. (2020). Job Strain as a Risk Factor for Peripheral Artery Disease: A Multi-Cohort Study. Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, 9(9)
Open this publication in new window or tab >>Job Strain as a Risk Factor for Peripheral Artery Disease: A Multi-Cohort Study
Show others...
2020 (English)In: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, ISSN 2047-9980, E-ISSN 2047-9980, Vol. 9, no 9Article in journal (Refereed) Published
Abstract [en]

Background Job strain is implicated in many atherosclerotic diseases, but its role in peripheral artery disease (PAD) is unclear. We investigated the association of job strain with hospital records of PAD, using individual-level data from 11 prospective cohort studies from Finland, Sweden, Denmark, and the United Kingdom. Methods and Results Job strain (high demands and low control at work) was self-reported at baseline (1985-2008). PAD records were ascertained from national hospitalization data. We used Cox regression to examine the associations of job strain with PAD in each study, and combined the study-specific estimates in random effects meta-analyses. We used τ2, I2, and subgroup analyses to examine heterogeneity. Of the 139 132 participants with no previous hospitalization with PAD, 32 489 (23.4%) reported job strain at baseline. During 1 718 132 person-years at risk (mean follow-up 12.8 years), 667 individuals had a hospital record of PAD (3.88 per 10 000 person-years). Job strain was associated with a 1.41-fold (95% CI, 1.11-1.80) increased average risk of hospitalization with PAD. The study-specific estimates were moderately heterogeneous (τ2=0.0427, I2: 26.9%). Despite variation in their magnitude, the estimates were consistent in both sexes, across the socioeconomic hierarchy and by baseline smoking status. Additional adjustment for baseline diabetes mellitus did not change the direction or magnitude of the observed associations. Conclusions Job strain was associated with small but consistent increase in the risk of hospitalization with PAD, with the relative risks on par with those for coronary heart disease and ischemic stroke.

Place, publisher, year, edition, pages
American Heart Association, 2020
Keywords
epidemiology, job strain, meta‐analysis, peripheral artery disease, risk factors
National Category
Cardiac and Cardiovascular Systems Public Health, Global Health, Social Medicine and Epidemiology Occupational Health and Environmental Health
Research subject
Individual and Society VIDSOC
Identifiers
urn:nbn:se:his:diva-18444 (URN)10.1161/JAHA.119.013538 (DOI)32342765 (PubMedID)2-s2.0-85084271212 (Scopus ID)
Available from: 2020-05-14 Created: 2020-05-14 Last updated: 2020-05-27Bibliographically approved
Vuorio, T., Suominen, S., Kautiainen, H. & Korhonen, P. (2019). Determinants of sickness absence rate among Finnish municipal employees. Scandinavian Journal of Primary Health Care, 37(1), 3-9
Open this publication in new window or tab >>Determinants of sickness absence rate among Finnish municipal employees
2019 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 37, no 1, p. 3-9Article in journal (Refereed) Published
Abstract [en]

Objective: In addition to acute health problems, various aspects of health behavior, work-related and sociodemographic factors have been shown to influence the rate of sickness absence. The aim of this study was to concomitantly examine factors known to have an association with absenteeism. We hypothesized the prevalence of chronic diseases being the most important factor associated with sickness absence. Design: A cross-sectional study. Setting: Occupational health care in the region of Pori, Finland. Subjects: 671 municipal employees (89% females) with a mean age of 49 (SD 10) years. Information about the study subjects was gathered from medical records, by physical examination and questionnaires containing information about physical and mental health, health behavior, work-related and sociodemographic factors. The number of sickness absence days was obtained from the records of the city of Pori. Main outcome measures: The relationship of absenteeism rate with sociodemographic, health- and work-related risk factors. Results: In the multivariate analysis, the mean number of chronic diseases (IRR 1.24, 95% CI 1.13 to 1.36), work ability (IRR 0.83, 95% CI 0.76 to 0.91), and length of years in education (IRR 0.90, 95% CI 0.85 to 0.95) remained as independent factors associated with absenteeism. Conclusion: According to our results, chronic diseases, self-perceived work ability and length of years in education are the most important determinants of the rate of sickness absence. This implies that among working-aged people the treatment of chronic medical conditions is also worth prioritizing, not only to prevent complications, but also to avoid sickness absences. KEY POINTS Various sociodemographic, health- and work- related risk factors have been shown to influence sickness absence. The study aimed to find the most important determinants of absenteeism among several known risk factors in Finnish municipal employees. Chronic diseases, self-perceived work ability and education years remained as the most important determinants of sickness absence rates. Treatment of chronic medical conditions should be prioritized in order to reduce sickness absence rate. © 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
Keywords
chronic disease, health behavior, occupational health care, sickness absence, sociodemographic factor, work ability, work-related factor
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Individual and Society VIDSOC
Identifiers
urn:nbn:se:his:diva-16630 (URN)10.1080/02813432.2019.1568710 (DOI)000463364700008 ()30689483 (PubMedID)2-s2.0-85060928514 (Scopus ID)
Available from: 2019-02-15 Created: 2019-02-15 Last updated: 2019-05-09
Ervasti, J., Airaksinen, J., Pentti, J., Vahtera, J., Suominen, S., Virtanen, M. & Kivimaki, M. (2019). Does increasing physical activity reduce the excess risk of work disability among overweight individuals?. Scandinavian Journal of Work, Environment and Health, 45(4), 376-385
Open this publication in new window or tab >>Does increasing physical activity reduce the excess risk of work disability among overweight individuals?
Show others...
2019 (English)In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 45, no 4, p. 376-385Article in journal (Refereed) Published
Abstract [en]

Objectives We examined the extent to which an increase in physical activity would reduce the excess risk of work disability among overweight and obese people (body mass index >= 25kg/m(2)).

Methods We used counterfactual modelling approaches to analyze longitudinal data from two Finnish prospective cohort studies (total N=38 744). Weight, height and physical activity were obtained from surveys and assessed twice and linked to electronic records of two indicators of long-term work disability (>= 90-day sickness absence and disability pension) for a 7-year follow-up after the latter survey. The models were adjusted for age, sex, socioeconomic status, smoking, and alcohol consumption.

Results The confounder-adjusted hazard ratio (HR) of long-term sickness absence for overweight compared to normal-weight participants was 1.43 [95% confidence interval (CI) 1.35-1.53]. An increase in physical activity among overweight compared to normal-weight individuals was estimated to reduce this HR to 1.40 (95% CI 1.31-1.48). In pseudo-trial analysis including only the persistently overweight, initially physically inactive participants, the HR for long-term sickness absence was 0.82 (95% CI 0.70-0.94) for individuals with increased physical activity compared to those who remained physically inactive. The results for disability pension as an outcome were similar.

Conclusions These findings suggest that the excess risk of work disability among overweight individuals would drop by 3-4% if they increased their average physical activity to the average level of normal-weight people. However, overweight individuals who are physically inactive would reduce their risk of work disability by about 20% by becoming physically active.

Place, publisher, year, edition, pages
Nordic Association of Occupational Safety and Health (NOROSH), 2019
Keywords
counterfactual analysis, mediation, normal weight; obesity, sickness absence, weight
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Individual and Society VIDSOC
Identifiers
urn:nbn:se:his:diva-17464 (URN)10.5271/sjweh.3799 (DOI)000473173000007 ()30640978 (PubMedID)2-s2.0-85069235654 (Scopus ID)
Available from: 2019-07-22 Created: 2019-07-22 Last updated: 2020-05-26
Koponen, A. M., Simonsen, N. & Suominen, S. (2019). How to promote fruits, vegetables, and berries intake among patients with type 2 diabetes in primary care?: A self-determination theory perspective. Health Psychology Open, 6(1)
Open this publication in new window or tab >>How to promote fruits, vegetables, and berries intake among patients with type 2 diabetes in primary care?: A self-determination theory perspective
2019 (English)In: Health Psychology Open, E-ISSN 2055-1029, Vol. 6, no 1Article in journal (Refereed) Published
Abstract [en]

The results of this study showed the importance of autonomous motivation for healthy eating. Autonomous motivation and female gender were the determinants most strongly associated with fruits, vegetables, and berries intake among patients with type 2 diabetes. Other determinants of fruits, vegetables, and berries intake were high education, high social support, high age, and a strong sense of coherence. Autonomous motivation and self-care competence mediated the effect of perceived autonomy support from a physician on fruits, vegetables, and berries intake. Thus, physicians can promote patients’ fruits, vegetables, and berries intake by supporting their autonomous motivation and self-care competence. The results are in line with self-determination theory.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
adherence, diabetes, diet, fruit and vegetable intake, self-determination theory
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Individual and Society VIDSOC
Identifiers
urn:nbn:se:his:diva-17320 (URN)10.1177/2055102919854977 (DOI)000471634900001 ()31218074 (PubMedID)2-s2.0-85067349786 (Scopus ID)
Available from: 2019-06-27 Created: 2019-06-27 Last updated: 2019-08-06Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-6648-603X

Search in DiVA

Show all publications