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Ragnar Ekstrand, M., Grandahl, M., Brolin, L., Friman, S., Kalinsky, A., Sjöö, H. & Stern, J. (2023). Kvinnor har positiva upplevelser första gynekologiska cellprovskontrollen - och ännu bättre om besöket sker på ungdomsmottagning. In: : . Paper presented at Reproduktiv hälsa, Karlstad, 3-4 oktober 2023.
Open this publication in new window or tab >>Kvinnor har positiva upplevelser första gynekologiska cellprovskontrollen - och ännu bättre om besöket sker på ungdomsmottagning
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2023 (Swedish)Conference paper, Oral presentation only (Other academic)
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:shh:diva-5090 (URN)
Conference
Reproduktiv hälsa, Karlstad, 3-4 oktober 2023
Available from: 2023-12-20 Created: 2023-12-20 Last updated: 2023-12-20Bibliographically approved
Stern, J., Funkquist, E.-L. & Grandahl, M. (2023). The association between early introduction of tiny tastings of solid foods and duration of breastfeeding. International Breastfeeding Journal, 18(1), Article ID 4.
Open this publication in new window or tab >>The association between early introduction of tiny tastings of solid foods and duration of breastfeeding
2023 (English)In: International Breastfeeding Journal, ISSN 1746-4358, E-ISSN 1746-4358, Vol. 18, no 1, article id 4Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Conflicting advice and non-evidence-based recommendations have a negative effect on breastfeeding. Since 2011, the National Food Agency in Sweden has informed parents that they can introduce tiny tastings (1 mL of solid food, i.e. other sources of nutrition than breastmilk/formula) to infants from four months of age. It is unknown how national recommendations, which differ from the Word Health Organisation's recommendation, affect breastfeeding. We hypothesised that introduction of tiny tastings of solid foods would shorten the duration of continued breastfeeding.

METHODS: This retrospective study utilises data from the longitudinal 'Swedish Pregnancy Planning Study', in which mothers were recruited at antenatal clinics on a national level. The participants completed three questionnaires up to one year after birth (n = 1,251). Linear regression models were used to analyse the association between the introduction of solid foods and the duration of breastfeeding.

RESULTS: As hypothesised, introduction of tiny tastings shortened the duration of continued breastfeeding. Half of all infants (48%) were fed with tiny tastings already in the fourth month. The correlation analysis showed that the earlier the infants started with tiny tastings, the earlier they ate larger amounts of solid food. In a multivariate linear regression analysis, five factors were identified as having a negative effect on the duration of breastfeeding: low infant age upon introduction of tiny tastings, low maternal age, low level of maternal education, high maternal BMI and twin birth.

CONCLUSIONS: Early introduction of tiny tastings of solid foods shortened the duration of breastfeeding. It is difficult to influence most conditions that affect breastfeeding, for example, the mother's educational level, BMI, age and if she has given birth to twins. In contrast, national guidelines can always be updated. Recommendations from the Swedish authorities should adhere to the WHO's recommendation, which states exclusive breastfeeding for six months and continued breastfeeding for at least two years or longer.

Keywords
Breastfeeding,  duration, Breastfeeding,  exclusive, Infant, Mother, Solid foods
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:shh:diva-4758 (URN)10.1186/s13006-023-00544-6 (DOI)36647140 (PubMedID)
Available from: 2023-03-20 Created: 2023-03-20 Last updated: 2023-03-20Bibliographically approved
Stern, J., Hasselberg, I., Lundstedt, R. & Grandahl, M. (2022). Availability of youth clinics and association with health outcomes: A Swedish register-based cross-sectional study. In: : . Paper presented at 16th Congress of the European Society of Contraception and Reproductive Health (ESCRH), Gent, Belgien, 25-28 maj 2022 (digital konferens).
Open this publication in new window or tab >>Availability of youth clinics and association with health outcomes: A Swedish register-based cross-sectional study
2022 (English)Conference paper, Poster (with or without abstract) (Other academic)
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:shh:diva-4635 (URN)
Conference
16th Congress of the European Society of Contraception and Reproductive Health (ESCRH), Gent, Belgien, 25-28 maj 2022 (digital konferens)
Available from: 2022-10-31 Created: 2022-10-31 Last updated: 2022-10-31Bibliographically approved
Stern, J., Molin, M. S., Fernaeus, M., Georgsson, S. & Carlsson, T. (2022). Contraceptive counseling about adverse reactions of intrauterine contraception: Exploration of narratives found in web-based discussion boards. Midwifery, 104, Article ID 103166.
Open this publication in new window or tab >>Contraceptive counseling about adverse reactions of intrauterine contraception: Exploration of narratives found in web-based discussion boards
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2022 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 104, article id 103166Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: the possibility of experiencing adverse reactions is an important aspect of contraceptive decision-making and information about this topic is highlighted as an essential aspect of contraceptive counseling. The aim of this study was to explore experiences of contraceptive counseling about potential adverse reactions of intrauterine contraception.

DESIGN: exploratory qualitative study of messages in discussion boards, analyzed with inductive qualitative content analysis.

SETTING: two large public Swedish web-based discussion boards about sexual and reproductive health.

PARTICIPANTS: threads related to the aim were identified through searches in the discussion boards during 2019 and 2020, resulting in in 43 included posters who had written 140 messages in total.

FINDINGS: the themes 'difficulties making an informed decision due to insufficient and untrustworthy information about adverse reactions' and 'feeling dismissed when communicating about experienced adverse reactions' illustrate the results. Posters emphasized the importance of sufficient information about adverse reactions. However, professionals were perceived as overly optimistic regarding intrauterine contraception and focusing on mild or common reactions. The importance of feeling that their adverse reactions were acknowledged was articulated, but posters felt that some professionals dismissed the reactions when being told about it, resulting in frustration and dissatisfaction with care. The discussion boards contained narratives describing a resistance among professionals to send in a formal report about the adverse reaction.

KEY CONCLUSIONS: according to statements made by posters who have experience of adverse reactions of intrauterine contraception, contraceptive counseling have room for improvement in regard to inclusion of comprehensive information about adverse reactions. The findings illustrate the importance that clients who experience adverse reactions of intrauterine contraception feel they are acknowledged and offered adequate support.

IMPLICATIONS FOR PRACTICE: echoing guidelines for high-quality contraceptive counseling, the narratives provide further weight that professionals need to have adequate training and resources to offer comprehensive information about adverse reactions of intrauterine contraception. The findings call attention to the importance of follow-up services for clients who experience adverse reactions.

Keywords
Adverse effects, Contraception, Counseling, Drug-related side effects and adverse reactions, Intrauterine devices, Pharmacovigilance, Social networking
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:shh:diva-4254 (URN)10.1016/j.midw.2021.103166 (DOI)34717242 (PubMedID)
Available from: 2021-12-07 Created: 2021-12-07 Last updated: 2022-10-13Bibliographically approved
Stern, J., Georgsson, S. & Carlsson, T. (2022). Quality of web-based information about the coronavirus disease 2019: A rapid systematic review of infodemiology studies published during the first year of the pandemic. BMC Public Health, 22(1), Article ID 1734.
Open this publication in new window or tab >>Quality of web-based information about the coronavirus disease 2019: A rapid systematic review of infodemiology studies published during the first year of the pandemic
2022 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 22, no 1, article id 1734Article, review/survey (Refereed) Published
Abstract [en]

BACKGROUND: Following the outbreak of the coronavirus disease 2019, adequate public information was of outmost importance. The public used the Web extensively to read information about the pandemic, which placed significant responsibility in, for many, an unfamiliar situation as the disease spread across the globe. The aim of this review was to synthesize the quality of web-based information concerning the coronavirus disease 2019 published during the first year of the pandemic.

MATERIALS AND METHODS: A rapid systematic review was undertaken by searching five electronic databases (CINAHL, Communication & Mass Media Complete, PsycINFO, PubMed, Scopus). Empirical infodemiology reports assessing quality of information were included (n = 22). Methodological quality and risk of bias was appraised with tools modified from previous research, while quality assessment scores were synthesized with descriptive statistics. Topics illustrating comprehensiveness were categorized with content analysis.

RESULTS: The included reports assessed text-based content (n = 13) and videos (n = 9). Most were rated good overall methodological quality (n = 17). In total, the reports evaluated 2,654 websites or videos and utilized 46 assessors. The majority of the reports concluded that websites and videos had poor quality (n = 20). Collectively, readability levels exceeded the recommended sixth grade level. There were large variations in ranges of the reported mean or median quality scores, with 13 of 15 total sample scores being classified as poor or moderate quality. Four studies reported that ≥ 28% of websites contained inaccurate statements. There were large variations in prevalence for the six categories illustrating comprehensiveness.

CONCLUSION: The results highlight quality deficits of web-based information about COVID-19 published during the first year of the pandemic, suggesting a high probability that this hindered the general population from being adequately informed when faced with the new and unfamiliar situation. Future research should address the highlighted quality deficits, identify methods that aid citizens in their information retrieval, and identify interventions that aim to improve the quality of information in the online landscape.

Keywords
COVID-19, Communicable diseases, Communication, Consumer health information, Health education, Internet, SARS-CoV-2
National Category
Nursing
Identifiers
urn:nbn:se:shh:diva-4608 (URN)10.1186/s12889-022-14086-9 (DOI)36096783 (PubMedID)
Available from: 2022-10-11 Created: 2022-10-11 Last updated: 2023-08-28Bibliographically approved
Stern, J., Lundberg, A. & Grip Orreborn, L. (2022). Swedish midwifery students’ education about men’s reproductive, perinatal, and sexual health: An empirical study of learning objectives. In: : . Paper presented at 16th Congress of the European Society of Contraception and Reproductive Health (ESCRH), Gent, Belgien, 25-28 maj 2022 (digital konferens).
Open this publication in new window or tab >>Swedish midwifery students’ education about men’s reproductive, perinatal, and sexual health: An empirical study of learning objectives
2022 (English)Conference paper, Poster (with or without abstract) (Other academic)
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:shh:diva-4634 (URN)
Conference
16th Congress of the European Society of Contraception and Reproductive Health (ESCRH), Gent, Belgien, 25-28 maj 2022 (digital konferens)
Available from: 2022-10-31 Created: 2022-10-31 Last updated: 2022-10-31Bibliographically approved
Stern, J., Georgsson, S. & Carlsson, T. (2021). Quality of web-based information at the beginning of a global pandemic: A cross-sectional infodemiology study investigating preventive measures and self care methods of the coronavirus disease 2019. BMC Public Health, 21(1), Article ID 1141.
Open this publication in new window or tab >>Quality of web-based information at the beginning of a global pandemic: A cross-sectional infodemiology study investigating preventive measures and self care methods of the coronavirus disease 2019
2021 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 21, no 1, article id 1141Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: reducing the spread and impact epidemics and pandemics requires that members of the general population change their behaviors according to the recommendations, restrictions and laws provided by leading authorities. When a new epidemic or pandemic emerges, people are faced with the challenge of sorting through a great volume of varied information. Therefore, the dissemination of high-quality web-based information is essential during this time period. The overarching aim was to investigate the quality of web-based information about preventive measures and self care methods at the beginning of the COVID-19 pandemic.

METHODS: in May 2020, consumer-oriented websites written in Swedish were identified via systematic searches in Google (n = 76). Websites were assessed with inductive content analysis, the JAMA benchmarks, the QUEST tool and the DISCERN instrument.

RESULTS: seven categories and 33 subcategories were identified concerning preventive measures (md = 6.0 subcategories), with few specifying a method for washing hands (n = 4), when to sanitize the hands (n = 4), and a method for sanitizing the hands (n = 1). Eight categories and 30 subcategories were identified concerning self care methods (md = 3.0 subcategories), with few referring to the national number for telephone-based counseling (n = 20) and an online symptom assessment tool (n = 16). Overall, the median total quality scores were low (JAMA = 0/4, QUEST =13/28, DISCERN = 29/80).

CONCLUSIONS: at the beginning of the pandemic, substantial quality deficits of websites about COVID-19 may have counteracted the public recommendations for preventive measures. This illustrates a critical need for standardized and systematic routines on how to achieve dissemination of high-quality web-based information when new epidemics and pandemics emerge.

Keywords
COVID-19, Consumer health information, Primary prevention, Self care, Severe acute respiratory syndrome coronavirus 2, World wide web
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:shh:diva-4121 (URN)10.1186/s12889-021-11141-9 (DOI)34126962 (PubMedID)
Available from: 2021-06-23 Created: 2021-06-23 Last updated: 2023-08-28Bibliographically approved
Delbaere, I. & Stern, J. (2020). Fertility (1ed.). In: Jill Shawe, Eric A.P. Steegers & Sarah Verbiest (Ed.), Preconception health and care: A life course approach (pp. 53-79). Springer
Open this publication in new window or tab >>Fertility
2020 (English)In: Preconception health and care: A life course approach / [ed] Jill Shawe, Eric A.P. Steegers & Sarah Verbiest, Springer , 2020, 1, p. 53-79Chapter in book (Other academic)
Place, publisher, year, edition, pages
Springer, 2020 Edition: 1
Keywords
Pre-pregnancy, Reproductive health, Women’s health, Men’s health, Women’s wellness, Healthy lifestyle, Fertility, Pregnancy planning, Maternal and infant health promotion
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:shh:diva-4182 (URN)10.1007/978-3-030-31753-9 (DOI)978-3-030-31752-2 (ISBN)
Available from: 2021-08-19 Created: 2021-08-19 Last updated: 2021-08-19Bibliographically approved
Grandahl, M., Stern, J. & Funkquist, E.-L. (2020). Longer shared parental leave is associated with longer duration of breastfeeding: a cross-sectional study among Swedish mothers and their partners. BMC Pediatrics, 20(1), Article ID 159.
Open this publication in new window or tab >>Longer shared parental leave is associated with longer duration of breastfeeding: a cross-sectional study among Swedish mothers and their partners
2020 (English)In: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 20, no 1, article id 159Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Breastfeeding is associated with health benefits for both the mother and infant and is therefore important to support; moreover, parental leave is a beneficial factor for breastfeeding. The Swedish parental leave is generous, allowing each parent to take 90 days; additionally, a further 300 days can be taken by either parent. Generally, mothers take 70% of the parental leave days, mainly during the first year. However, breastfeeding duration has declined in the last decade, and it is not known how shared parental leave is associated with the duration of breastfeeding.

AIM: To investigate how parental leave is associated with the duration of exclusive and partial breastfeeding of the infant during the first 12 months after birth. An additional aim was to describe infants' and parents' characteristics and mode of birth in association with the duration of exclusive and partial breastfeeding.

METHODS: This cross-sectional study was part of the Swedish Pregnancy Planning Study, conducted in Sweden in 2012-2015. The parents were recruited at 153 antenatal clinics in nine counties. In total, 813 couples completed a follow-up questionnaire 1 year after birth. Linear regression models were used to analyse the association between parental leave and the duration of breastfeeding.

RESULTS: Infants were exclusively breastfed for, on average, 2.5 months (range 0-12 months) and partially breastfed, on average, 7 months (range 0-12 months). Most of the parental leave was taken by the mother (mean = 10.9 months) during the infant's first 12 months, while the partner took 3 months, on average. The parental leave (used and planned) during the infant's first 24 months were, on average, 21 months. In the multivariate linear regression analysis, mothers' and partners' high level of education (p < 0.001, p = 0.044, respectively), mothers' higher age (p = 0.049), non-instrumental vaginal birth (p = 0.004) and longer parental leave for the first 24 months (p < 0.001) were associated with longer duration of partial breastfeeding.

CONCLUSION: The duration of partial breastfeeding was associated with higher parental educational level, higher age, non-instrumental vaginal birth and longer parental leave.

Keywords
Breastfeeding, Equal health, Infant, Mode of delivery, Parental leave, Partner, Socioeconomics
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:shh:diva-3699 (URN)10.1186/s12887-020-02065-1 (DOI)32290823 (PubMedID)
Available from: 2020-05-08 Created: 2020-05-08 Last updated: 2021-10-05Bibliographically approved
Grandahl, M., Bodin, M. & Stern, J. (2019). In everybody's interest but no one's assigned responsibility: midwives' thoughts and experiences of preventive work for men's sexual and reproductive health and rights within primary care. BMC Public Health, 19(1), Article ID 1423.
Open this publication in new window or tab >>In everybody's interest but no one's assigned responsibility: midwives' thoughts and experiences of preventive work for men's sexual and reproductive health and rights within primary care
2019 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 19, no 1, article id 1423Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Sexual and reproductive health and rights (SRHR) have historically been regarded as a woman's issue. It is likely that these gender norms also hinder health care providers from perceiving boys and men as health care recipients, especially within the area of SRHR. The aim of this study was to explore midwives' thoughts and experiences regarding preventive work for men's sexual and reproductive health and rights in the primary care setting.

METHODS: An exploratory qualitative study. Five focus group interviews, including 4-5 participants in each group, were conducted with 22 midwives aged 31-64, who worked with reproductive, perinatal and sexual health within primary care. Data were analysed by latent content analysis.

RESULTS: One overall theme emerged, in everybody's interest, but no one's assigned responsibility, and three sub-themes: (i) organisational aspects create obstacles, (ii) mixed views on the midwife's role and responsibility, and (iii) beliefs about men and women: same, but different.

CONCLUSIONS: Midwives believed that preventive work for men's sexual and reproductive health and rights was in everybody's interest, but no one's assigned responsibility. To improve men's access to sexual and reproductive health care, actions are needed from the state, the health care system and health care providers.

Keywords
Equal health, Gender norms, Health care providers, Health promotion, Men, Midwives, Sexual and reproductive health and rights, Social model of health
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:shh:diva-3519 (URN)10.1186/s12889-019-7792-z (DOI)31666036 (PubMedID)
Available from: 2019-11-27 Created: 2019-11-27 Last updated: 2023-08-28Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-2753-9140

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