Erik Grasaas

• Sandbakk, Øyvind Bucher & Grasaas, Erik (2026). Despite what we know, physical activity continues to decline: can integrating physical activity and education be a way forward? Frontiers in Sports and Active Living. 8. doi: 10.3389/fspor.2026.1832941. Full text in Research Archive Show summary

  Despite decades of robust evidence on the benefits of regular physical activity, the fitness and health of young people are in worrying decline worldwide. Today, around 80% of adolescents fail to meet recommended daily activity levels, a trend which parallels an increase in youth overweight and obesity rates. This perspective paper examines the wide-ranging consequences of inactivity in adolescence, ranging from heightened long-term risks of chronic disease and rising healthcare burdens, to negative impacts on mental health, well-being, and the development of self-efficacy in adolescence. We discuss the possible promises and pitfalls of organized sport as a traditional strategy to engage youth in physical activity: while sports participation is linked to better physical and mental health outcomes, many adolescents seems to drop out of sport in their mid-teens due to factors such as early specialization, competitive pressures, cost, and social disparities. Therefore, we argue that youth inactivity will require a broader, more inclusive approach that goes beyond the sports club model, and propose integrating substantial daily physical activity into school curricula as a universal foundation for fitness and health. By reimagining schools as key platforms for physical activity—in partnership with community sports programs—and by implementing bold, multi-sector policies to reduce barriers to active lifestyles, society can begin to bridge the gap between what we know and what we practice. Translating knowledge into action is crucial to safeguard the health, well-being, and future resilience of the next generation.

• Grasaas, Erik; Sandbakk, Øyvind Bucher; Grasaas, Christina Åsan & Ostojic, Sergej (2026). Sport engagement and life satisfaction in late childhood: a population-based analysis. Frontiers in Sports and Active Living. 8. doi: 10.3389/fspor.2026.1784535. Full text in Research Archive Show summary

  Background: While sport participation and physical activity are widely recognized as beneficial for children's well-being, limited research has examined how the frequency of sport engagement relates to life satisfaction (LS) in late childhood. This study aimed to (1) describe the frequency of sport participation, active transport, and LS among Norwegian children aged 10–12 years, and (2) assess the associations between sport participation frequency, active transport mode, and LS, with attention to gender differences.Methods: Cross-sectional data were drawn from the 2024 Norwegian Ungdata Junior Survey, comprising 46,941 children aged 10–12 years. Participants completed an electronic questionnaire during school hours. Linear regression models were used to examine associations between sport participation frequency, transport mode, and LS (measured on a 0–10 scale), adjusting for socioeconomic status, grade level, and centrality, and stratified by gender.Results: Boys reported significantly higher LS than girls (mean 8.4 vs. 7.7, p < 0.01). Among boys, LS increased with sport participation frequency, from 8.0 (no evenings) to 8.6 (five evenings per week). In contrast, girls' LS remained relatively stable across participation levels (7.7–7.8). Regression analysis showed the strongest positive associations with LS observed for children participating in organized sports one to three evenings per week. No significant associations were found between type of transport and LS for either gender.Conclusions: In a large sample of representative Norwegian children aged 10–12 years of age, LS scores for boys progressed by the frequency of weekly sport participation but remained stable for girls. Still, the strongest positive associations between sport participation and LS were among those engaging in sports one to three sessions per week, which suggests that a balanced approach to youth sports, emphasizing enjoyment, autonomy, and social connection, may be more effective in promoting well-being than maximizing participation frequency in late childhood.

• Grasaas, Erik; Bjørnsen, Gunn & Elmies-Vestergren, Anne (2026). Global Perspectives on Teacher Education: Innovations and Challenges in International Contexts: Lessons from Norway. Journal of the International Society for Teacher Education. ISSN 1029-5968. 29(2), p. 83–92. doi: 10.26522/jiste.v29i2.5196. Full text in Research Archive Show summary

  A new national curriculum (LK20) was implemented in Norway in 2020, which integrates three cross-curricular themes: Public Health and Life Skills, Democracy and Citizenship, and Sustainable Development. The introduction of these three themes must be understood in the Norwegian national teacher education landscape due to their ability to shape societal development. Research has uncovered challenges and opportunities in teacher education such as teachers’ experiences of responsibility for deliverables that go beyond their competence. The Norwegian teacher program was elevated to a five-year master’s degree in 2017, underpinning the strength of a high professional standard and research-based teaching, and the close partnership with schools which enables innovative and interdisciplinary perspectives. To meet the increasing demands placed on teachers, the teacher education vision for the future needs to be adaptive and embrace the importance of a cross-curricular themes, to facilitate relevant student learning which will support students to face tomorrow’s challenges.

• Grasaas, Erik; Ostojic, Sergej; Stea, Tonje Holte & Sandbakk, Øyvind Bucher (2026). Prior-night sleep duration and the relationship to quality of life and educational context in Norwegian pre-adolescents. BMC Pediatrics. 26. doi: 10.1186/s12887-026-06830-6. Full text in Research Archive Show summary

  Sufficient sleep is associated with improved development, health, and quality of life (QoL). The aim of this paper is twofold: (1) to describe prior-night sleep duration according to sleep recommendations across socioeconomic status (SES), age, gender and screen time use among Norwegian pre-adolescents and (2) to explore the association between reported prior-night sleep duration with QoL and school factors stratified by gender. Cross-sectional data was aggregated from the Norwegian Ungdata Junior Survey, collected in 2024. In total, 45,185 children aged between 10 and 12 years provided self-reported data anonymously by filling out an electronic/online questionnaire during school hours. About half of the study sample (53.1%) reported adherence to international sleep recommendations for children aged 10 to 12 years, with somewhat higher adherence among boys than girls(54.5% vs. 51.8%, p &lt; 0.01). Results from binary regressions revealed positive associations related to QoL and school factors among children adhering to sleep recommendations compared to ones not adhering, with adjusted odds ratio ranging from 1.33 to 1.79 (all p &lt; 0.01). In this population-based sample of Norwegian children aged 10 to 12 years, approximately half reported not achieving the recommended 9 to 12 h of sleep per night. Reporting prior-night sleep duration in accordance to the international sleep recommendations were strongly associated with higher QoL and positive school related factors among boys and girls, but particularly strong among girls. These findings emphasize the vital role of adequate sleep among pre-adolescents for QoL and optimizing school contexts, offering valuable insight for future practice and policy. 1. Why is this study needed? Children aged 10 to 12 years are recommended to obtain 9 to 12&nbsp;h of sleep per day to support optimal health and development. However, global evidence indicates that between one-third to one-half of children report failing to meet these recommendations. 2. What is the key problem/issue/question this manuscript addresses? The aims of this paper were twofold: (1) to describe prior-night sleep duration according to the sleep recommendation across age, socioeconomic levels, gender and screen time use among Norwegian children aged 10 to 12 years and (2) to explore the association between reported prior-night sleep duration with quality of life and school factors stratified by gender. 3. What is the main point of your study? Research specifically examining sleep adherence and quality of life in Norwegian pre-adolescents is scarce. This study addresses that gap by providing novel data from a large population-based Norwegian sample, offering insight into potential cultural and age-specific differences. 4. What are your main results and what do they mean? This research identifies associations between children’s prior-night sleep duration and indicators of quality of life in an educational context, offering insights that may inform practice and policy development by highlighting the potential importance of sleep for daily functioning and well-being among children in Norway.

• Jahre, Henriette; Guddal, Maren Hjelle; Grasaas, Erik; Smedbråten, Kaja; Riiser, Kirsti & Pripp, Are Hugo [Show all 8 contributors for this article] (2025). The Effectiveness of School‐Based Interventions on Pain and Disability Outcomes in Adolescents With Persistent Pain. A Systematic Review. European Journal of Pain. ISSN 1090-3801. 29(8). doi: 10.1002/ejp.70101. Full text in Research Archive Show summary

  ABSTRACT Background and Objective Persistent pain is common among adolescents, with significant consequences. School‐based interventions have the potential to reach most adolescents, but there is a lack of systematic reviews addressing school‐based pain interventions. This systematic review aimed to identify and evaluate the effectiveness of school‐based interventions for reducing persistent pain and disability in adolescents compared to control interventions. Databases and Data Treatment The PRISMA guidelines were followed (CRD42023477721). Searches in Medline, EMBASE, PEDro, CINAHL, Web of Science, Cochrane, AMED, PsycINFO, and Google Scholar identified 6651 studies. We included randomised controlled trials (RCTs) and controlled trials (CTs) of interventions conducted at schools involving adolescents aged 10–19 years with persistent pain lasting ≥ 3 months. Risk of bias was measured using the Cochrane RoB 2 tool for RCTs and ROBINS‐I for CTs. Results were synthesised narratively. Results Sixteen studies met the inclusion criteria ( n  = 12 RCTs, n  = 3 CTs, n  = 1 pilot RCT) including 2873 participants. The identified interventions were relaxation, education, exercise, taping, and tailored pain management. Relaxation reduced headache activity in four out of five studies; exercise was effective for back and menstrual pain; education showed conflicting results; and person‐centred care was not better than usual school health care for reducing pain. All included studies had a high risk of bias. Conclusion Relaxation and exercise showed promising effectiveness on reducing persistent pain in adolescents, although with a high risk of bias. The need for higher‐quality studies remains imperative to strengthen the evidence base and inform future interventions. Significance Statement This systematic review highlights the potential of school‐based interventions, particularly relaxation and exercise, in reducing persistent pain among adolescents, although in studies with a high risk of bias. These findings underscore the need for higher‐quality studies to establish robust evidence and inform effective, equitable pain management strategies in school settings.

• Grasaas, Erik; Rohde, Gudrun E.; Mikkelsen, Hilde Elisabeth Timenes; Helseth, Sølvi; Hagen, Milada & Skarstein, Siv [Show all 7 contributors for this article] (2025). The relationship between parental self-efficacy, health-related quality of life, stress and educational level on adolescents’ self-efficacy: a cross-sectional study. Journal of Health, Population and Nutrition. ISSN 1606-0997. 44. doi: 10.1186/s41043-025-01163-z. Full text in Research Archive Show summary

  Background Self-efficacy is a well-known concept often referred to as the belief in the ability to perform in different situations. The concept of self-efficacy is particularly relevant during adolescence, as it serves as a self-regulatory mechanism through which adolescents can be motivated to change their behavior by significant others, such as parents. However, there is little research evidence on how parental factors are associated with adolescents’ self-efficacy. Hence, this current paper aimed to describe parental self-efficacy, health-related quality of life (HRQOL), stress, and educational level and explore associations between the participating parent’s self-efficacy, HRQOL, stress, and educational level on adolescents’ self-efficacy stratified by gender. Methods A cross-sectional study was performed among 508 Norwegian adolescent-parent dyads. Adolescents were 13–15 years old and completed an electronic survey during school hours with teacher and researcher present, whereas the participating parent completed the survey at home. The Survey comprised of a test battery of questionnaires, including sociodemographic data, self-efficacy for both adolescents and parents, and the parental factors: stress, HRQOL, and educational level. Separate multivariable regressions were conducted for the participating parent using STATA software. Results Descriptive analyses revealed a self-efficacy score of (mean/standard deviation (SD), 32.9 (4.0) vs. 34.1 (4.3)), HRQOL (mean/SD, PCS 51.1 (9.5) vs. 53.3 (7.0), MCS 51.9 (8.2) vs. 54.1 (7.2)) and stress (mean/SD, 0.28 (0.24) vs. 0.25 (0.15) among mothers and fathers respectively. Half of the mothers (506%) and 46.1% of the fathers reported ≥ 16 years of education. Multivariable regressions revealed all nonsignificant associations of all parental study variables on adolescents’ self-efficacy (all p > 0.05). Conclusions In this study, the parental factors examined were not associated with adolescents’ self-efficacy. These findings highlight the need for further observational and longitudinal studies with larger samples to better understand how parental factors influence adolescents’ self-efficacy.

• Ostojic, Sergej & Grasaas, Erik (2025). Dietary Creatine and Hydration Biomarkers in the General Population: NHANES 1999–2023. Food Science & Nutrition. 13(7). doi: 10.1002/fsn3.70524. Full text in Research Archive Show summary

  Creatine is widely recognized for its performance-enhancing and neuroprotective properties; however, its impact on hydration status at the population level remains poorly understood. This study investigated the relationship between dietary creatine intake and hydration biomarkers in a nationally representative sample derived from the National Health and Nutrition Examination Survey (NHANES). Data from the biannual 1999 and 2023 NHANES cycles were harmonized and analyzed, including dietary recall data and hydration biomarkers such as plasma osmolality, urine specific gravity (USG), total body water (TBW), intracellular fluid (ICF), and extracellular fluid (ECF) volumes. Valid data on dietary creatine intake were obtained from 98,681 participants, with serum osmolality measured in 69,144 individuals, fluid volumes assessed in 12,369, and USG evaluated in 6274 respondents. Total daily dietary creatine intake was expressed in milligrams per kilogram of body mass and categorized into quantiles. Associations were evaluated using multivariate regression models, adjusted for potential confounders, including gender, age, daily intake of caffeine, alcohol, sodium, water, protein, and total caloric intake. Both the lowest and highest creatine intake quantiles were significantly associated with altered plasma osmolality levels and an increased prevalence of hypoosmolality (p < 0.01), relative to moderate creatine intake (4.27–10.19 mg/kg). Higher creatine intake was also associated with reduced TBW, ICF, and ECF volumes (p < 0.01). Notably, a significantly lower risk of hypoosmolality was observed in the 50th percentile (OR = 0.861; p = 0.035) and the 75th percentile (OR = 0.832; p = 0.010) of creatine intake. Our findings challenge the prevailing notion that dietary creatine universally enhances hydration. While moderate intake from regular foods appears to have a neutral effect, higher intake levels may disrupt systemic fluid balance. Further research is warranted to explore the underlying physiological mechanisms and evaluate the long-term effects of creatine intake on hydration homeostasis.

• Grasaas, Erik & Sandbakk, Øyvind Bucher (2025). Life Satisfaction across Sports Disciplines and Sports Categories among Norwegian Adolescents: Comparisons to National Data. Frontiers in Psychology. 16. doi: 10.3389/fpsyg.2025.1577326. Full text in Research Archive Show summary

  Background: Adolescence is a crucial time for engagement in physical activity (PA) as it linked to higher life satisfaction (LS) and future health. However, adolescents’ LS within the specific sport disciplines remains unexplored. The objective of this paper was to (1) describe LS, training behaviors and pain across 18 sports disciplines among Norwegian adolescents stratified by gender and (2) compare LS between the different sports disciplines and sports categories with nationwide data. Methods: Cross-sectional data was derived from the Norwegian Youngdata Survey, collected with nationwide representation, aggregated from 2021 to 2023. A total of 26.171 adolescents aged 16 to 19 years were included, derived from 18 sports disciplines (e.g., football, handball, etc.) and grouped into categories (e.g., endurance sports, team sports, etc.). Comparisons to national data (N = 109.469) were conducted using summary data t-tests. Results: Adolescents participating in cross-country (XC) skiing revealed the highest school satisfaction, highest PA levels, lowest pain and lowest painkiller usage across sport disciplines. Fifteen out of 18 sports disciplines revealed higher LS compared to national data, with substantial association in motorsport, XC skiing, football and handball (all, p < 0.002). All sport categories revealed higher LS compared to national data (all, p < 0.01), whereas the strongest associations were unveiled among girls (all, p < 0.002). Conclusion: Participation in sports, regardless of category, is associated with increased LS of Norwegian adolescents, with strongest associations unveiled among girls. With this research, we add further insights into adolescents’ life satisfaction, training, pain and painkiller use, providing novel sport-specific knowledge of both healthy and risk-behavior.

• Grasaas, Erik; Sandbakk, Øyvind Bucher; Ostojic, Sergej; Horverak, May Olaug & Stea, Tonje Holte (2025). Socioeconomic status, sport participation, and school-related outcomes among Norwegian adolescents: a cross-sectional analysis. Frontiers in Sports and Active Living. 7. doi: 10.3389/fspor.2025.1613391. Full text in Research Archive Show summary

  Background: Extensive research highlights the critical role of sport and physical activity (PA) engagement during adolescence, as it is strongly associated with enhanced subjective well-being, reduced risk of mental health problems, and prevention of chronic diseases in adulthood. Thus, it is highly important to identify key barriers of sport participation in adolescence. The present study aimed to; (1) describe socioeconomic status (SES) across different sport disciplines among current participants and sport dropouts, (2) examine possible associations between sport participation and sport dropouts on school-related outcomes. Methods: School-based cross-sectional data among 90,091 adolescents aged 16–19 years were collected across Norway between 2021 and 2023. A self-report questionnaire was used to assess information about sociodemographic background, current and previous sport participation, and school-related factors, including perceived school stress, teacher care, feeling tired at school and sense of belonging at school. Adjusted binary logistic regressions were conducted using IBM SPSS Statistics. Results: Adolescents currently participating in sport reported higher SES compared to sport dropouts (2.13 ± 0.51 vs. 1.97 ± 0.61, p < 0.01). Tennis participants demonstrated the highest SES of 2.39 ± 0.44, while motorsport participants revealed the lowest score (1.82 ± 0.49). The highest sport attrition rate (80.2%) was revealed among adolescents from the lowest SES level. Current sport participants reported favorable school-related outcomes and PA engagement compared to sport dropouts (all, p < 0.01). Adjusted logistic analyses showed that participation in sport activities was associated with lower odds of perceived school stress [OR = 0.83; 95% CI (0.81–0.86)] and being tired during school hours [OR = 0.74; 95% CI (0.71–0.77)], and higher odds for perceived teacher care [OR = 1.17; 95% CI (1.12–1.22)] and perceived sense of belonging [OR = 1.36; 95% CI (1.31–1.42)]. Conclusions: Higher SES was found among adolescents participating in sport compared to sport dropouts, underscoring the importance of promoting affordable sport opportunities during adolescence. Current sport participation was associated with favorable school-related outcomes compared to sport dropouts, such as lower odds for perceived school stress and tiredness in school, and higher odds of perceived sense of belonging in school and perceived teacher care.

• Grasaas, Erik; Ostojic, Sergej & Sandbakk, Øyvind Bucher (2024). Associations between levels of physical activity and satisfaction with life among Norwegian adolescents: a cross-sectional study. Frontiers in Sports and Active Living. 6. doi: 10.3389/fspor.2024.1437747. Full text in Research Archive Show summary

  Background: A robust association between physical activity (PA) and satisfaction with life (SWL) has been established, wherein self-efficacy has been identified as a mediator across different populations. However, there is a need to further examine the relationship between PA and SWL and whether self-efficacy act a as mediator within different levels of PA among Norwegian adolescents. Thus, the objective of this study was to explore the relationship between levels of PA and SWL by testing for self-efficacy as a possible mediator.<p><p> Methods: Cross-sectional data from the 2022 Norwegian Ungdata Survey was utilized. Data included demographics and various health data that was collected anonymously. The electronic survey took place in classrooms and was administered by the respective teacher. Permission to access and use data was approved by the Norwegian Agency for Shared Services in Education and Research (SIKT). Statistical analyses were conducted using the PROCESS macro by Andrew Hayes for SPSS software. <p>Results: Descriptive findings revealed that girls reported lower self-efficacy than boys (14.2 vs. 15.5, with a maximum of 20) and lower SWL (6.8 vs. 7.6, with a maximum of 10). About one out of five girls and one out of seven boys reported no days of weekly PA, whereas 4% of girls and 9.5% of boys adhered to the PA-recommendation of 60-min of daily exercise. Associations between PA levels and SWL was mediated by self-efficacy (all p < 0.05), with the highest indirect effect (56.3%) revealed in the association between those adhering to the PA-recommendations and SWL. <p>Conclusions: Norwegian girls reported more sedentary behavior, less PA, lower self-efficacy, and lower SWL than boys across all grade levels. Mediation analysis revealed that up to 56.3% of the enhancement in SWL among those adhering to 60-min of PA recommendations was explained by increased self-efficacy. Norwegian government and policymakers should promote initiatives and regulations focusing on higher levels of PA to foster a resilient adolescent population with higher individual beliefs and higher subjective wellbeing.

• Medin, Anine Christine; Vik, Frøydis Nordgård; Helle, Christine; Helland, Sissel Heidi; Wills, Andrew Keith & Osorio, Natalie Garzon [Show all 22 contributors for this article] (2024). Scaling up evidence-based digital early life nutrition interventions in a county setting: an implementation trial – protocol for Phase 2 of the Nutrition Now project. Frontiers in Public Health. 11. doi: 10.3389/fpubh.2023.1326787. Full text in Research Archive Show summary

  Background: Few effective health interventions transition from smaller efficacy or effectiveness studies to real-world implementation at scale, representing a gap between evidence and practice. Recognising this, we have developed Nutrition Now – a tailored digital resource building on four efficacious dietary interventions, aiming to improve nutrition in the important first 1,000 days of life. Nutrition Now targets and guides expectant parents and parents of 0–2 year olds, serves as a reliable source of evidence-based information for midwives and public health nurses at maternal and child healthcare (MCH) centres, and offers pedagogical tools for early childhood education and care (ECEC) staff. The aim of this study is to implement Nutrition Now at scale and evaluate the impact of different sets of multifaceted implementation strategies on implementation outcomes. Methods: A quasi-experimental design with three study arms will be used, providing either low, medium or high implementation support, when rolled out in 50 municipalities in 2 counties in Norway. Nutrition Now will be implemented in MCH and ECEC settings and made available to expectant parents and parents of 0–2 year olds through social media and MCH. The implementation support builds on strategies described in the Expert Recommendations for Implementing Change (ERIC) implementation framework and is informed by dialogues with stakeholders. Impact of the different degree of implementation support will be assessed by examining reach, adoption, fidelity, and sustainability using usage data generated from the Nutrition Now resource, publicly available municipal data and qualitative interviews with MCH and ECEC staff. Discussion: Nutrition Now Phase 2 will break new ground by scaling up successively delivered and complementary dietary interventions in the first 1,000 days of life in a real-life context. The project also seeks to identify what level of implementation support is most effective when implementing digital, scalable, evidence-based early-life nutrition interventions in community settings. The project will inform implementation research and provide knowledge about effective implementation strategies to be used in a national scale-up of Nutrition Now. Trial registration: The study is registered prospectively (submitted 14/06/2022, registration date: 19/06/2022) in the International Standard Randomised Controlled Trial Number registry (ISRCTN): reg. Number: ISRCTN10694967, https://doi.org/10.1186/ISRCTN10694967.

• Grasaas, Erik & Sandbakk, Øyvind Bucher (2024). Adherence to physical activity recommendations and associations with self-efficacy among Norwegian adolescents: trends from 2017 to 2021. Frontiers in Public Health. 12. doi: 10.3389/fpubh.2024.1382028. Full text in Research Archive Show summary

  Background: The crucial role of physical activity (PA) in promoting well-being and overall health of adolescents is widely acknowledged. Previous global studies have consistently revealed low adherence to PA recommendations among adolescents, emphasizing potential links between PA engagement and self-efficacy in school-based populations. However, there is a need for further exploration of this relationship, in particularly gender differences and taking into account the potential influences of the COVID-19 pandemic. The objective of this study is to provide a comprehensive description of adherence to PA recommendations and its associations with self-efficacy in Norwegian schoolbased adolescents over the period from 2017 to 2021.<p><p> Methods: Cross-sectional data on physical activity (PA) levels and selfefficacy among 13–19-year-old Norwegian adolescents were collected from the Norwegian Ungdata Survey during the period 2017 to 2021. The survey, conducted in Norwegian lower- and upper-secondary schools, was administered electronically during school hours. All data collected is anonymous and has received approval from the Norwegian Agency for Shared Services in Education and Research (SIKT). Statistical analyses were performed using SPSS software. <p>Results: Girls consistently exhibited lower adherence to PA recommendations (17.6–19.8%) compared to boys (27.7–31.1%) each year from 2017 to 2021 (all p  <  0.01). Similarly, girls reported lower self-efficacy (14.1 to 14.8 out of 20) than boys (15.5 to 15.9) during the same period (all p  <  0.01). Regression analyses highlighted robust positive associations between PA and self-efficacy in those adhering to PA recommendations (i.e., physically active at least 5 times a week) and strong inverse associations for those reporting inactivity (never active) in both girls and boys from 2017 to 2021. <p>Conclusion: Adolescents in Norway report PA adherence ranging from 15 to 30%, with girls consistently exhibiting lower adherence to PA recommendations and reporting lower self-efficacy than boys. Notably, there are substantial associations between self-efficacy and both adherence to PA recommendations and inactivity over time. These findings underscore the significance of promoting adherence to PA recommendations during adolescence, especially among girls. Policymakers in Norway should focus on initiatives to increase PA levels among adolescents in both lower and upper secondary schools.

• Grasaas, Erik; Ostojic, Sergej; Sandbakk, Øyvind Bucher; Bjørnsen, Gunn; Sylta, Øystein & Major, Daniel Høgli [Show all 7 contributors for this article] (2024). The relationship between perceived school stress and satisfaction with life among Norwegian school-based adolescents and the moderating role of perceived teacher care: a cross-sectional study. BMC Public Health. 24(1). doi: 10.1186/s12889-024-20246-w. Full text in Research Archive Show summary

  Background - Perceived stress from schoolwork and perceived teacher care are shown to influence adolescents’ life satisfaction. However, there is a need to further explore how levels of perceived school stress affect life satisfaction of Norwegian adolescents across gender and school levels using nationwide data, and whether this association is moderated by perceived teacher care. Hence, this paper sought to: (1) describe perceived school stress, perceived teacher care and satisfaction with life in Norwegian adolescents stratified by gender and school level, (2) examine the association between perceived school stress and satisfaction with life by testing perceived teacher care as a possible moderator and (3) explore the association between perceived teacher care and adolescents’ satisfaction with life.<p> <p>Methods - We utilized cross-sectional data from the Norwegian Ungdata Survey from 2021, encompassing adolescents from lower and upper secondary school. Two-thirds of all Norwegian adolescents participated in the Ungdata Survey from 2021. All data is anonymous. The study variables are presented according to lower and upper secondary school as well as gender. Linear regressions were conducted and adjusted for socioeconomic status (SES) by using SPSS.<p> <p>Results - In total, 139,841 adolescents were included. Girls exhibited higher perceived school stress, lower perceived teacher care, and lower life satisfaction than boys in both lower and secondary school (all p < 0.01). Strong inverse associations on satisfaction with life were found in both genders in lower and upper secondary school among those who reported very frequent perceived school stress, with perceived teacher care moderating the relationship (B= -0.67; 95% CI [-0.70 to -0.65], P < 0.01]). Moreover, robust associations were unveiled between high and low levels of perceived teacher care and life satisfaction across gender and school level.<p> <p>Conclusions - Higher perceived school stress was strongly inversely associated with life satisfaction in Norwegian adolescents, in both girls and boys, and in both lower and secondary school. Teacher care was identified as a moderator and seems to play a crucial part in the everyday life of Norwegian adolescents. These implications extend to teacher education, practice, and policy, which should be aware of the pivotal role of perceived teacher care on Norwegian school-based adolescents‘ life satisfaction.

• Grasaas, Erik; Ostojic, Sergej & Jahre, Henriette (2024). Adherence to sleep recommendations is associated with higher satisfaction with life among Norwegian adolescents. BMC Public Health. 24(1). doi: 10.1186/s12889-024-18725-1. Full text in Research Archive Show summary

  Background: Sleep plays a crucial role in the health and well-being of adolescents; however, inadequate sleep is frequently reported in numerous countries. This current paper aimed to describe sleep duration, factors impacting sleep, consequences of insufficient sleep and satisfaction with life in Norwegian adolescents, stratified by sex and by adherence to the 8-hour sleep recommendation, and to examine potential associations between adherence to the 8-hours sleep recommendation and satisfaction with life. Methods: This is a cross-sectional study using data from the Norwegian Ungdata Survey, collected in 2021. Adolescents from five Norwegian counties were included, comprising a total of 32,161 upper secondary school students. Study variables were collected through an electronic questionnaire administered during school hours and all data are anonymous. Descriptive data of sleep patterns are presented, and linear regressions were conducted adjusting for SES, perceived stress, physical activity level, over-the-counter analgesics use, grade level and screen time. Results: 73% of adolescents did not adhere to the 8-hours of sleep recommendation per night, with similar results for girls and boys. 64% reported tiredness at school (minimum 1–2 days weekly) and 62% reported that screen time negatively affected their ability to sleep. 23% reported that gaming affected their sleep, with a higher prevalence in boys than girls. Satisfaction with life score was 7.0 ± 1.9 points (out of 10) for the total sample, with higher scores for boys (7.3 ± 1.8 points) than girls (6.9 ± 1.9 points). Regressions revealed a positive association with satisfaction with life (B = 0.31, 95% [0.15 to 0.48]) in adolescents adhering to sleep recommendation of 8h compared to the ones not adhering to the sleep recommendation. Conclusions: Most Norwegian adolescents fail to adhere to the 8-hours of sleep recommendation and the majority feel tired at school or during activities. More than half of adolescents reported that screen time negatively affected their ability to sleep. Adhering to the sleep recommendation was associated with higher life satisfaction. Our findings highlight the importance of sufficient sleep in adolescents, while future research is needed to examine other sleep related measures on adolescents´ satisfaction with life.

• Grasaas, Erik; Hysing, Mari & Sandbakk, Øyvind Bucher (2024). The relationship between sleep duration and physical activity level among Norwegian adolescents: a cross-sectional study. Frontiers in Public Health. 12, p. 1–9. doi: 10.3389/fpubh.2024.1495826. Full text in Research Archive Show summary

  Background: Failure to adhere to sleep and physical activity recommendations among adolescents constitutes a public health problem. However, the associations between sleep duration and adolescents’ physical activity levels remain less explored. The aims of this paper were twofold: (1) to describe sleep and physical activity levels among Norwegian school-based adolescents, stratified by school level and sex and (2) to explore the association between sleep and physical activity levels. Methods: Data were derived from the 2022 Norwegian Ungdata Survey, totaling 63,113 adolescents from lower (aged 13 to 16 years) and upper (aged 16 to 19 years) secondary schools. Study variables were measured using single-item questions from the Ungdata survey and collected through an electronic questionnaire administered during school hours. Logistic regressions were performed using crude analysis and adjusted for Socioeconomic status (SES) and grade level (age). Results: In lower secondary school, 57.0% of girls and 44.7% of boys reported sleeping less than the recommended 8 h, whereas in upper secondary school, the rate was 74.9% among girls and 74.3% among boys. Girls consistently reported more sleep problems, feeling more tired at school or during activities, and less physical activity than boys across school levels. Sleep duration was a significant predictor for all levels of weekly physical activity among girls across school levels, with the highest odds revealed in upper secondary school among those being active 5 times a week (B = 1.32; 95% CI [1.24 to 1.40]). Sleep duration was a predictor for being active 5 times a week for boys across school levels (B = 1.22; 95% CI [1.17 to 1.27]). Conclusion: About half of younger adolescents and three-quarters of older adolescents do not adhere to the sleep recommendation. Lower levels of physical activity were consistently reported by girls than boys. Sleep duration consistently predicted a 20 to 30% higher likelihood of being active at least 5 days a week across sex and school levels. These findings underscore the critical role of sleep duration relations to higher physical activity levels among Norwegian adolescents. Government and policymakers should encourage healthy sleep and PA habits by explicitly incorporating guidelines into the curriculum.

• Skarstein, Siv; Helseth, Sølvi; Hagen, Milada; Haraldstad, Kristin; Rohde, Gudrun Elin & Mikkelsen, Hilde E. Timenes [Show all 7 contributors for this article] (2024). Use of Over-The-Counter Analgesics is Associated with Pain, Stress, and Quality of Life in Norwegian Adolescents: A Cross-Sectional Study. Children. 11(10), p. 1–11. doi: 10.3390/children11101247. Full text in Research Archive Show summary

  Introduction: Approximately 20% of Norwegian adolescents are frequently using Over-the-Counter Analgesics (OTCAs). The WHO emphasizes the need for research to identify the key determinants of health problems in adolescence. Thus, our aim was to describe and explore pain, stress, and Health-Related Quality of Life (HRQOL) in Norwegian adolescents and investigate possible associations upon high/low usage of OTCAs. Methods: This cross-sectional study included 315 adolescents (92 boys, 223 girls) with an average age of 14.1 years (13–15 years). All participants reported using OTCAs. Weekly usage was categorized as high and less than weekly as low. Using a validated questionnaire, we explored the following variables: pain, as measured using the Brief Pain Inventory, stress (Perceived Stress Questionnaire), and HRQOL (KIDSSCREEN-27). Binary logistic regression models were conducted using IBM SPSS Statistics (version 27). Results: Our descriptive findings reveal that high users of OTCAs reported higher pain intensity of 3.4 (SD = 1.9) and perceived stress of 0.38 (SD = 0.18) compared to low users, who reported 2.5 (SD = 1.9) and 0.32 (SD = 0.16), respectively. High OTCA users reported lower average scores than low users across all HRQOL subscales. Binary logistic regression revealed 30% higher odds for higher levels of pain intensity and 14 times higher odds of perceived stress associated with being a high user of OTCAs compared to a low user. Conclusions: Our study shows significantly higher odds for experiencing pain and stress among adolescents using OTCAs daily-to-weekly, compared to those seldom using such medicines. Health professionals should be aware of young people who have a high consumption of OTCAs and investigate whether the use is related to pain or stress. This might be important in designing a personalized and appropriate intervention. Parents and caregivers have an important responsibility in supporting adolescents’ appropriate pain management. Longitudinal studies are needed to better explore predictive factors of OTCA use in adolescents, particularly in relation to psychological variables such as stress and quality of life.

• Baltic, Sonja; Grasaas, Erik & Ostojic, Sergej (2024). Creatine and sleep habits and disorders in the general population aged 16 years and over: NHANES 2007-2008. Nutrition and Health. ISSN 0260-1060. doi: 10.1177/02601060241299958. Full text in Research Archive
• Baltic, Sonja; Grasaas, Erik & Ostojic, Sergej (2024). Dietary creatine and carcinogenic biomarkers in adult population. Nutrition and Health. ISSN 0260-1060. doi: 10.1177/02601060241291694. Full text in Research Archive
• Ostojic, Sergej; Grasaas, Erik; Baltic, Sonja & Cvejic, Jelena (2024). Dietary creatine is associated with lower serum neurofilament light chain levels. Applied Physiology, Nutrition and Metabolism. ISSN 1715-5312. 49(8), p. 1121–1123. doi: 10.1139/apnm-2024-0064. Full text in Research Archive
• Valen, Erlend Larsen; Grasaas, Erik; Engeset, Dagrun; Salvesen, Lorentz; Skeie, Guri & Øverby, Nina Cecilie [Show all 7 contributors for this article] (2023). Myfood24 på norsk: et selvadministrert digitalt 24-timers kostintervju. Norsk tidsskrift for ernæring (NTFE). ISSN 1503-5034. 21(2), p. 13–22. doi: 10.18261/ntfe.21.2.3. Full text in Research Archive Show summary

  Innen ernæringsepidemiologien er vi i stor grad avhengige av å estimere inntak av mat og næringsstoffer basert på selvrapportering, til tross for at denne tilnærmingen er beheftet med målefeil. Graden av målefeil har betydning for analyser og tolkning av resultater, så metodene vi bruker bør være så valide som mulig. Å utvikle brukervennlige kostholdsmetoder som reduserer belastning for deltaker kan være et viktig bidrag til mer nøyaktig rapportering, samtidig som tids- og ressursbruken begrenses. Det digitale kostholdsverktøyet myfood24, opprinnelig utviklet ved Universitetet i Leeds, kan enten brukes som et selvadministrert 24-timers kostintervju, eller matdagbok. Verktøyet har de siste årene blitt oversatt og kulturelt tilpasset til flere land, både i og utenfor Europa, og har blitt validert i en rekke ulike aldersgrupper. I 2019 startet arbeidet med å lage en norsk versjon av myfood24. Det er allerede gjennomført en valideringsstudie av bilder av porsjonsstørrelser som inngår i den norske versjonen, og det planlegges å validere verktøyet ytterligere. Hensikten med denne artikkelen er å beskrive utviklingsarbeidet som er gjort. Målet er at norske myfood24 også skal kunne brukes av andre norske forskere, og med denne artikkelen ønsker vi å gjøre informasjon om verktøyet tilgjengelig.

• Grasaas, Erik; Mikkelsen, Hilde Elisabeth Timenes; Haraldstad, Kristin; Helseth, Sølvi; Hagen, Milada & Skarstein, Siv [Show all 7 contributors for this article] (2023). Pain in Adolescence: Maternal and Paternal Factors Affecting Adolescents’ Pain in Norway—A Cross-Sectional Study. Children. 10(12). doi: 10.3390/children10121915. Full text in Research Archive Show summary

  Background: Pain in adolescence is considered a worldwide concern. Adolescents’ pain affects family functioning. However, bidirectional associations should be considered as parental determinates such as pain, stress, and sociodemographic factors are also shown to influence pain in adolescence. Objectives: This study explored the associations between maternal and paternal sociodemographic factors, pain, and stress and adolescents’ pain, and stress on adolescents’ pain. Methods: In total, 508 school-based Norwegian adolescents with a corresponding parent were included. All adolescents completed an electronic survey during school hours, and their respective parents responded electronically. The survey included sociodemographic data, the Perceived Stress Questionnaire, and the Brief Pain Inventory. Results: Herein, 385 adolescents reported an average pain of 2.1 (SD, 1.9), and 308 of the participating parents reported an average pain of 1.6 (SD, 1.8). Regressions stratified by parental gender revealed nonsignificant associations in fathers’ study variables predicting adolescents’ pain. However, having the highest maternal educational level (p ≤ 0.01) and working part-time (p ≤ 0.01) were associated with lower pain in adolescents. Conclusions: The findings of this study demonstrated that sociodemographic factors such as high educational status in mothers and mothers working part-time were associated with lower pain in Norwegian adolescents. These findings highlight the importance of a holistic approach to pain management in adolescence.

• Grasaas, Erik; Rohde, Gudrun E.; Haraldstad, Kristin; Helseth, Sølvi; Småstuen, Milada Cvancarova & Skarstein, Siv [Show all 7 contributors for this article] (2023). Sleep duration in schooldays is associated with health-related quality of life in norwegian adolescents: a cross-sectional study. BMC Pediatrics. 23(1). doi: 10.1186/s12887-023-04306-5. Full text in Research Archive Show summary

  Background Insufficient sleep is commonly reported in adolescence and is negatively associated with a wide range of health outcomes. A way to grasp the complicated challenge of how sleep impact different aspects of the adolescents´ everyday life is by examining the relationship between sleep duration in schooldays and weekends on different health-related quality of life (HRQOL) subscales. Furthermore, to expand the understanding of possible underlying mechanisms between sleep and HRQOL, testing for self-efficacy as a possible mediator is of importance. Methods A cross-sectional study was performed among 696 adolescents aged 13–15 years from a schoolbased setting. All participants completed an electronic survey in their respective classrooms. The survey included demographic data, the School Sleep Habits Survey, the KIDSCREEN-27 questionnaire measuring HRQOL, and the General Perceived Self-Efficacy Scale. Statistical analyses were conducted using SPSS Statistics software including PROCESS macro by Andrew Hayes. Results Our findings revealed overall similar sleep patterns in boys and girls including longer sleep duration in the study sample during weekends (10:09 h) than in schooldays (08:36 h). Regression analyses revealed that sleep duration in schooldays was positively and statistically associated with HRQOL subscales psychological well-being (95% CI [0.44 to 1.33]), autonomy and parents (95% CI [0.12 to 1.06]), school environment (95% CI [0.47 to 1.40]), and self-efficacy (95% CI [0.01 to 0.47]). Sleep duration in weekends revealed no associations with the HRQOL subscales, except for the HRQOL subscale psychological well-being (95% CI [0.09 to 0.85]). Mediation analyses revealed that sleep duration in schooldays explained most of the associations (64 −75%) in 4 out 5 HRQOL subscales, except in the association with the HRQOL subscale physical well-being revealing an indirect effect of 71.9%. Conclusions This cross-sectional study described sleep among Norwegian adolescents and demonstrated that sleep durations in weekends and schooldays impact HRQOL and self-efficacy, revealing overall better outcome in HRQOL and self-efficacy with sufficient sleep during schooldays. These findings support the regularity of sleep and highlight the importance of sufficient sleep during schooldays, especially in a school-based sample of adolescents.

• Ostojic, Sergej; Grasaas, Erik & Jelena, Cvejic (2023). Dietary creatine and cancer risk in the U.S. population: NHANES 2017–2020. Journal of Functional Foods. ISSN 1756-4646. 108. doi: 10.1016/j.jff.2023.105733. Full text in Research Archive Show summary

  While creatine is generally considered a safe dietary compound, there have been concerns about excessive creatine intake and its possible link to cancer. The main of this study was to examine the relationship between dietary creatine intake and cancer risk in the general US population using data from the 2017–2020 National Health and Nutrition Examination Survey (NHANES). We extracted a dataset that included information on medical conditions and dietary intake from 7,344 NHANES respondents. We used individual data files containing detailed information about each food and beverage item consumed to calculate creatine intake from meat- and milk-based food sources. In a subset of NHANES respondents who reported their cancer status, the average daily creatine intake was 11.6 ± 11.5 mg per kg body mass (95 % CI, 11.3 to 11.8); all participants in the subset were 20 years or older. Cancer-free individuals consumed significantly more creatine per day than those with cancer (11.7 ± 11.6 mg/kg body mass vs. 10.6 ± 10.2 mg/kg body mass; P = 0.01). The odds ratio for having cancer in the subset of participants consuming < 10.5 mg of creatine per kg body mass daily (the 50th percentile of consumption) compared to those with higher intake (≥10.5 mg) was 1.18 (95 % CI, from 1.01 to 1.37), indicating a significant association between lower dietary creatine intake and increased cancer risk (P = 0.03). Our findings suggest that consuming a diet that includes more creatine may be associated with a reduced risk of cancer or malignancy in U.S. adults aged 20 years and over, with the average difference in creatine intake between cancer-free individuals and cancer groups was relatively small (1.1 mg/kg body mass). Further studies are necessary to confirm the potential benefits of creatine-rich foods or dietary supplements in the management of cancer.

• Grasaas, Erik; Helseth, Sølvi; Fegran, Liv; Stinson, Jennifer; Småstuen, Milada Cvancarova & Lalloo, Chitra [Show all 7 contributors for this article] (2022). App-based intervention among adolescents with persistent pain: a pilot feasibility randomized controlled trial. Pilot and Feasibility Studies. 8. doi: 10.1186/s40814-022-01113-0. Full text in Research Archive Show summary

  Background: Persistent pain in adolescence adversely afects everyday life and is an important public health problem. The primary aim was to determine the feasibility of an 8-week app-based self-management intervention to reduce pain and improve health-related quality of life in a community-based population of adolescents with persistent pain. A secondary aim was to explore diferences in health outcomes between the intervention and control groups. Methods: A sample of 73 adolescents aged 16–19 years with persistent pain from a community-based population were randomized into 2 groups. The intervention group received the Norwegian culturally adapted version of the iCanCope with PainTM app, which includes symptom tracking, goal setting, self-management strategies, and social support. The attention control group received a symptom tracking app. Feasibility was assessed as attrition rates and level of engagement (interactions with the app). The secondary outcomes included pain intensity, health-related quality of life, self-efcacy, pain self-efcacy, perceived social support from friends, anxiety and depression, and patient global impression. Statistical analyses were conducted using SPSS. Results: Demographic and baseline outcome variables did not difer between the 2 groups. No diferences were found between the participants completing the study and those who withdrew. Twenty-eight adolescents completed the intervention as planned (62% attrition). Both groups had a low level of app engagement. Intention-to-treat analysis (n = 19 + 14) showed no signifcant diferences in outcomes between groups. However, the large efect size (Cohen’s d = .9) for depression suggested a lower depression score in the intervention group. Conclusions: High treatment attrition and low engagement indicate the need for changes in trial design in a fullscale randomized controlled trial to improve participant retention.

• Helland, Sissel Heidi; Bjørkkjær, Tormod; Grasaas, Erik & Øverby, Nina Cecilie (2022). Staff feeding practices, food neophobia, and educational level in early education and care settings: A cross-sectional study. Appetite. ISSN 0195-6663. 180. doi: 10.1016/j.appet.2022.106379. Full text in Research Archive
• Grasaas, Erik; Skarstein, Siv; Mikkelsen, Hilde Elisabeth Timenes; Småstuen, Milada Cvancarova; Rohde, Gudrun E. & Helseth, Sølvi [Show all 7 contributors for this article] (2022). The relationship between stress and health-related quality of life and the mediating role of self-efficacy in Norwegian adolescents: a cross-sectional study. Health and Quality of Life Outcomes. 20, p. 1–9. doi: 10.1186/s12955-022-02075-w. Full text in Research Archive
• Sylte, Mari; Grasaas, Erik & Haraldstad, Kristin (2021). Living with pain in adolescence- a qualitative study. Sykepleien Forskning. ISSN 1890-2936. 16. doi: 10.4220/Sykepleienf.2021.86940en. Full text in Research Archive Show summary

  Background: Pain is a major health concern and increasing numbers of adolescents experience persistent pain. More girls than boys are aected. Living with pain aects a person’s quality of life and is related to sleeplessness, stress, depression, and absence from school. For many, the pain becomes severe and persistent, lasting into adulthood.Objective: To describe how young people experience living with persistent pain, how this aects their everyday life and schoolwork, and what they themselves are doing to cope with their pain. Method: The study has a qualitative design and is based on individual interviews with seven adolescents with persistent pain. Results: One of the study’s main ndings was that the young people experienced a great deal of stress and pressure in their everyday lives, and that they generally linked their pain to this strain. Stress associated with school and schoolwork was of particular concern. The informants did not wish to be absent from school because of their pain, and most of them were not talking to anybody about these problems. The results also showed that most of the informants had no eective strategy for coping with pain. Conclusion: The young informants felt a lack of support and found that they had insucient information and inadequate strategies for coping with pain. Because pain can have serious consequences in the short and long term, it is important that health promoting eorts emphasise pain prevention and strategies for coping with pain, to stop the pain from becoming chronic or persistent. Public health nurses are familiar with ways of coping with pain and stress and have an important role to play in giving information to children and their parents and providing guidance for adolescents in how to cope with pain.

• Sylte, Mari; Grasaas, Erik & Haraldstad, Kristin (2021). Å leve med smerter i ungdomstiden- en kvalitativ studie av ungdommers erfaringer. Sykepleien Forskning. ISSN 1890-2936. 16. doi: 10.4220/Sykepleienf.2021.86940. Full text in Research Archive Show summary

  Bakgrunn: Smerter er et av våre store helseproblemer, og stadig ere unge har langvarige smerter. Flere jenter enn gutter er rammet. Det å leve med smerter går ut over livskvaliteten og har sammenheng med søvnproblemer, stress, depresjon og fravær fra skolen. For mange blir smerten alvorlig og langvarig og varer til voksen alder.Hensikt: Å beskrive hvordan ungdommer erfarer å leve med langvarige smerter, hvordan det virker inn på hverdagen og skolen, og hva ungdommene selv gjør for å mestre smertene. Metode: Studien har et kvalitativt design og omfatter individuelle intervjuer med sju ungdommer som har langvarige smerter. Resultat: Et av hovedfunnene i studien var at ungdommene opplevde mye stress og press i hverdagen, og at de knyttet smertene i stor grad til dette. Det gjaldt særlig stress knyttet til skole og skolearbeid. Ungdommene ønsket ikke å være borte fra skolen på grunn av smerter, og de este snakket ikke med andre om disse problemene. Videre viste resultatene at de este ungdommene mangler eektive strategier for smertemestring. Konklusjon: Ungdommene opplevde mangel på støtte, informasjon og eektive strategier for å mestre smertene. Fordi smerter kan ha alvorlige konsekvenser både på kort og lang sikt, er det viktig at man i det helsefremmende arbeidet legger vekt på å forebygge smerter og bidra til mestring, slik at ikke smertene blir kroniske eller langvarige. Helsesykepleiere har kunnskap om mestring av smerte og stress. De har en viktig rolle i å informere både barn og foreldre og veilede ungdommer når det gjelder smertemestring.

• Sylte, Mari; Grasaas, Erik & Haraldstad, Kristin (2021). Ungdommer som lever med smerter opplever mer stress i hverdagen. Forskning.no. ISSN 1891-635X. Full text in Research Archive
• Vik, Frøydis Nordgård; Grasaas, Erik; Polspoel, Maaike E. M.; Røed, Margrethe; Hillesund, Elisabet Rudjord & Øverby, Nina Cecilie (2021). Parental phone use during mealtimes with toddlers and the associations with feeding practices and shared family meals : a cross-sectional study. BMC Public Health. 21. doi: 10.1186/s12889-021-10757-1. Full text in Research Archive Show summary

  Background: Positive parental feeding practices and a higher frequency of family meals are related to healthier child dietary habits. Parents play an essential role when it comes to the development of their child’s eating habits. However, parents are increasingly distracted by their mobile phone during mealtimes. The aim of this study was to describe the feeding practices and daily shared family meals among parents who use and do not use a mobile phone during mealtimes, and further to explore the associations between the use of a mobile phone during mealtimes and feeding practices and daily shared family meals, respectively. Methods: Cross-sectional data from the Food4toddler study were used to explore the association between mobile use during meals and parental feeding practices including family meals. In 2017/2018 parents of toddlers were recruited through social media to participate in the study. In total 298 out of 404 who volunteered to participate, filled in a baseline questionnaire, including questions from the comprehensive feeding practices questionnaire (CFPQ), questions of frequency of family meals and use of mobile phone during meals. Results: Herein, 4 out of 10 parents reported various levels of phone use (meal distraction) during mealtimes. Parental phone use was associated with lower use of positive parental feeding practices like modelling (B = − 1.05 (95% CI -1.69; − 0.41)) and family food environment (B = − 0.77 (95% CI -1.51; − 0.03)), and more use of negative parental feeding practices like emotional regulation (B = 0.73 (95% CI 0.32; 1.14)) and the use of pressure to eat (B = 1.22 (95% CI 0.41; 2.03)). Furthermore, parental phone use was associated with a lower frequency of daily family breakfast (OR = 0.50 (95% CI 0.31; 0.82)) and dinner (OR = 0.57 (95% CI 0.35; 0.93)). Conclusions: Mobile phone use is common among parents during mealtimes, and findings indicate that parental phone use is associated with less healthy feeding practices and shared family meals. These findings highlight the importance of making parents aware of potential impacts of meal distractions.

• Grasaas, Erik & Broberg, Camilla (2020). «Tren deg stødig» - Effekten av kombinerte treningsintervensjoner for fallforebygging hos eldre: En litteraturstudie. Fysioterapeuten. ISSN 0016-3384. 8, p. 8–13. Full text in Research Archive
• Grasaas, Erik; Helseth, Sølvi; Fegran, Liv; Stinson, Jennifer; Småstuen, Milada Cvancarova & Haraldstad, Kristin (2020). Health-related quality of life in adolescents with persistent pain and the mediating role of self-efficacy: a cross-sectional study. Health and Quality of Life Outcomes. 18(19). doi: 10.1186/s12955-020-1273-z. Full text in Research Archive Show summary

  Background: Persistent pain has a high prevalence among adolescents. Pain has been shown to reduce all aspects of the adolescent’s health-related quality of life (HRQOL). In adult patients with pain, self-efficacy has been shown to mediate the relationship between pain intensity, disability and depression. However, little is known about whether self-efficacy acts as a mediating variable in the relationship between persistent pain and HRQOL sub-scale scores in a school-based population of adolescents. Objectives: To describe the experience of pain, HRQOL and self-efficacy, and to explore the association between pain intensity, general self-efficacy and HRQOL in adolescents with persistent pain by testing self-efficacy as a possible mediator. Methods: The study participants were 78 adolescents with persistent pain, aged 16–19 years, who were recruited from five high schools in southern Norway. All participants completed an electronic survey consisting of the Lubeck Pain Questionnaire, which included a visual analogue scale (VAS) measuring pain intensity, the General Self-Efficacy Scale (GSE) and the KIDSCREEN-52 Questionnaire measuring HRQOL. Statistical analyses were conducted using the PROCESS macro for SPSS developed by Andrew Hayes. Results: All participants reported pain in multiple locations, of which the head was most common (88.5%). Mean (SD) pain intensity score of the participants was 5.4 (1.8). The study sample had poor HRQOL, with mean (SD) scores for several sub-scales ranging from 45.2 (21.0) to 91.0 (13.3) on a 0–100 scale. The associations between pain intensity and the HRQOL sub-scales of physical well-being, psychological well-being, mood, self-perception, autonomy and school environment were mediated by self-efficacy. The highest degree of mediation and, thus, the largest indirect effect was estimated for the HRQOL sub-scale physical well-being (67.2%). Conclusions: This school-based sample of adolescents with persistent pain had impaired HRQOL. Up to 67% of the reduction in the HRQOL sub-scale scores for physical well-being, psychological well-being, mood, self-perception, autonomy and school environment could be explained by the mediating variable self-efficacy. Thus, future painmanagement interventions that aim to increase HRQOL in school-based populations of adolescents with persistent pain should consider promoting self-efficacy and providing more targeted interventions.

• Grasaas, Erik; Fegran, Liv; Helseth, Sølvi; Stinson, Jennifer; Martinez, Santiago & Lalloo, Chitra [Show all 7 contributors for this article] (2019). iCanCope With Pain: Cultural Adaptation and Usability Testing of a Self-Management App for Adolescents With Persistent Pain in Norway. JMIR Research Protocols. 8(6), p. 1–14. doi: 10.2196/12940. Full text in Research Archive
• Grasaas, Erik; Hegge, Ann Magdalen; Ettema, Gerardus Johannes C & Sandbakk, Øyvind (2014). The effects of poling on physiological, kinematic and kinetic responses in roller ski skating. European Journal of Applied Physiology. ISSN 1439-6319. 114(9), p. 1933–1942. doi: 10.1007/s00421-014-2926-6. Full text in Research Archive

View all works in NVA

• Grasaas, Erik (2026). Barn trives best med moderat mengde organisert trening - fvn.no. [Internet]. FVN og Ungdata Nyheter. Full text in Research Archive Show summary

  Ved å studere 47.000 barn har forskere funnet ut hvor mange treninger i uka som gir høyest livskvalitet.

• Grasaas, Erik (2026). Søvn og skolestart. [Radio]. NRK. Full text in Research Archive
• Grasaas, Erik (2026). Hyppighet av idrettsdeltakelse blant barn. [Radio]. NRK . Full text in Research Archive
• Grasaas, Erik (2026). Søvn og fotball VM. [Radio]. NRK . Full text in Research Archive
• Grasaas, Erik (2026). Søvnen som forsvant. [Journal]. Aftenposten . Full text in Research Archive Show summary

  Jonas Hanstad (18) kan bruke både én og to timer på å sovne.

• Grasaas, Erik (2026). Det er tortur å stå opp tidlig. [Journal]. Aftenposten . Full text in Research Archive
• Grasaas, Erik (2025). HMN 2025: How to Reduce the barriers that cause young people to quit sports. [Internet]. HealthMedicinet. doi: http:/healthmedicinet.com/hmn-2025-how-reducing-the-barriers-that-cause-young-people-to-quit-sports/. Full text in Research Archive
• Grasaas, Erik (2025). 3 beste søvntips. [Internet]. Instagram . Full text in Research Archive
• Grasaas, Erik (2025). Slår alarm om unge i idretten - en tikkende bombe. [Journal]. FVN. doi: https:/www.fvn.no/sport/i/OoG62O/slaar-alarm-om-unge-i-idretten-en-tikkende-bombe. Full text in Research Archive
• Grasaas, Erik (2025). Klasseskille i idretten - en tikkende bombe? doi: https:/www.uia.no/arrangementer/lordagsuniversitetet/program/kristiansand/oktober25-2. Full text in Research Archive
• Grasaas, Erik (2025). Mister nattesøvn - tøft for foreldre å ta denne kampen. [Journal]. KRS - Kristiansand Avis. doi: https:/www.krs.no/skjermtid-og-sovn-slik-pavirkes-unge-i-kristiansand/s/5-157-522605. Full text in Research Archive
• Grasaas, Erik (2025). Mange ungdommer slutter med idrett: ­– Å bevege seg og få hjertet til å slå er det viktigste. [Journal]. Forskning.no. doi: https:/www.forskning.no/barn-og-ungdom-idrett-partner/mange-ungdommer-slutter-med-idrett-a-bevege-seg-og-fa-hjertet-til-a-sla-er-det-viktigste/2543104. Full text in Research Archive
• Grasaas, Erik (2025). Neste generasjons idrettsmodell starter i klasserommet. [Journal]. VG. doi: https:/www.vg.no/sport/i/dRKV9z/neste-generasjons-idrettsmodell-starter-i-klasserommet. Full text in Research Archive
• Grasaas, Erik (2025). Sosioøkonomiske forskjeller i idretten. [Radio]. NRK Sørlandet. Full text in Research Archive
• Grasaas, Erik (2025). Erik ser en voksende kløft mellom barna: – En ond sirkel. [Journal]. KRS - Kristiansand Avis. Full text in Research Archive
• Grasaas, Erik (2025). Sovet dårlig i natt? Slik overlever du dagen i dag. [Internet]. NRK. doi: https:/www.nrk.no/norge/darlig-sovn_-7-eksperttips-for-a-fungere-bedre-dagen-etter-1.17571131. Full text in Research Archive
• Jahre, Henriette; Guddal, Maren Hjelle; Grasaas, Erik; Grotle, Margreth; Riiser, Kirsti & Smedbråten, Kaja [Show all 7 contributors for this article] (2024). The effectiveness of school-based interventions on pain and disability in adolescents with persistent pain. A systematic review. Full text in Research Archive
• Jahre, Henriette; Guddal, Maren Hjelle; Grasaas, Erik; Smedbråten, Kaja; Riiser, Kirsti & Grotle, Margreth [Show all 7 contributors for this article] (2024). Skoleintervensjoner for vedvarende smerter hos ungdommer. En systematisk oversiktsartikkel. Full text in Research Archive
• Grasaas, Erik (2024). Søvn og fornøydhet med livet blant ungdommer. [TV]. NRK Sørlandet TV og Radio. Full text in Research Archive
• Grasaas, Erik (2024). Lite søvn går utover livskvaliteten. [Internet]. NRK. Full text in Research Archive Show summary

  https://www.nrk.no/sorlandet/sovnproblemer-blant-norske-ungdommer-pavirker-livskvaliteten-1.17012265

• Grasaas, Erik (2024). Unge sover for lite. [TV]. NRK TV og NRK radio (P2) . Full text in Research Archive
• Guddal, Maren Hjelle; Grasaas, Erik; Smedbråten, Kaja; Riiser, Kirsti; Grotle, Margreth & Øiestad, Britt Elin (2024). The effectiveness of school-based interventions on pain and disability in adolescents with persistent pain. A systematic review. Full text in Research Archive
• Guddal, Maren Hjelle; Grasaas, Erik; Smedbråten, Kaja; Riiser, Kirsti; Grotle, Margreth & Øiestad, Britt Elin (2024). Skoleintervensjoner for vedvarende smerter hos ungdommer. En systematisk oversiktsartikkel. Full text in Research Archive
• Jahre, Henriette; Guddal, Maren Hjelle; Grasaas, Erik; Smedbråten, Kaja; Riiser, Kirsti & Grotle, Margreth [Show all 7 contributors for this article] (2024). skoleintervensjoner for vedvarende smerter hos ungdommer. En systematisk oversiktsartikkel. Full text in Research Archive
• Grasaas, Erik (2024). Støtte fra læreren fungerer som en buffer mot stress. Spesielt for jentene. [Internet]. forskning.no. Full text in Research Archive
• Grasaas, Erik (2024). Støtte fra læreren er nøkkelen til mindre stress og bedre livskvalitet. [Internet]. utdanningsnytt.no. Full text in Research Archive
• Eide, Øyvind & Grasaas, Erik (2024). En time daglig aktivitet i grunnskolen - hvorfor er vi ikke der ennå? Full text in Research Archive
• Grasaas, Erik (2024). Lærerstøtte gir mindre stress og bedre livskvalitet. [Journal]. Skolemagasinet . Full text in Research Archive
• Grasaas, Erik (2023). Søvn bør på pensum på ungdomsskolen. Full text in Research Archive
• Øverby, Nina Cecilie; Hillesund, Elisabet Rudjord; Helland, Sissel Heidi; Helle, Christine; Wills, Andrew Keith & Lamu, Admassu Nadew [Show all 23 contributors for this article] (2023). Evaluating the effectiveness and implementation of evidence-based early-life nutrition interventions in a community setting a hybrid type 1 non-randomized trial – the Nutrition Now project protocol. Frontiers in Endocrinology. 13. doi: 10.3389/fendo.2022.1071489. Full text in Research Archive Show summary

  Disappointingly few efficacious health interventions are successfully scaled up and implemented in real world settings. This represents an evidence-to-practice gap, with loss of opportunity to improve practice. Aiming to improve nutrition in the first 1000 days of life, we have combined four efficacious dietary interventions into a single adapted digital resource (Nutrition Now) for implementation in a Norwegian community setting. Nutrition Now targets pregnant women and parents of 0–2-year-olds with messages focusing on healthy dietary behaviours. Early childhood education and care (ECEC) staff are provided with pedagogical tools addressing healthy food exposure and child food acceptance. Objectives: a) evaluate the effectiveness of provision of the Nutrition Now resource on child diet and diet-related outcomes, with special attention to the influence of socio-economic position, b) gather information on the effectiveness of the implementation process to inform forthcoming scale-up and c) perform trial- and model-based economic evaluations. This is a hybrid type 1 implementation study, focusing on evaluation of effectiveness. A quasi-experimental design with pre- and post-tests, where one municipality gets access to the resource (n~800), while a matched non-equivalent control municipality (n~800) does not, will be used. Effectiveness will be assessed by examining e.g., diet outcomes, developmental outcomes, and feeding practices. The resource will be implemented in ECEC settings and made available to pregnant women and parents through the Norwegian system of maternal and child health (MCH) care. The implementation process includes iterative adjustments and implementation strategies from the implementation framework Expert Recommendations for Implementing Change (ERIC) informed by dialogues with stakeholders. Implementation outcomes (e.g., acceptability and adoption) will be assessed through questionnaires and interviews with parents, ECEC and MCH staff, with particular attention to ethnic diverse groups. Both within-trial and modelling-based economic evaluation will be performed. Nutrition Now will bridge the existing evidence-to-practice gap through rigorous scientific effectiveness evaluation of municipal scale up and inform subsequent county scale up. The study is the first to implement efficacious nutrition interventions in early life with potential for health improvement using technology to maximise the reach and impact of both parental and MCH dietary guidance and ECEC practice.

• Vik, Frøydis Nordgård; Grasaas, Erik & Øverby, Nina Cecilie (2021). Sjekker du mobilen og svarer på et par mail mens smårollingen spiser? Full text in Research Archive
• Sandbakk, Øyvind; Grasaas, Christina Åsan & Grasaas, Erik (2013). Physiological determinants of sprint and distance performance level I elite cross-country skiers. Full text in Research Archive
• Ettema, Gertja; Grasaas, Christina Åsan; Grasaas, Erik & Sandbakk, Øyvind (2013). Changes in technique after high-intensity exercise during roller ski skating. Full text in Research Archive
• Grasaas, Erik (2020). iCanCope with PainTM Norway : Cultural translation and feasibility testing of the Norwegian iCanCope with PainTM app aimed at reducing pain and improving health-related quality of life in a school-based population of adolescents with persistent pain. Universitetet i Agder. ISSN 9788271179908. Full text in Research Archive Show summary

  Persistent pain has a high prevalence among adolescents. Pain has been shown to reduce all aspects of the adolescent’s health-related quality of life (HRQOL). Available pain-coping applications (apps) are rarely scientifically evaluated nor have health personnel in their development. Thus, there is a need to provide coping strategies in evidence- and theory-based app interventions aimed at reducing pain and increasing HRQOL among adolescents with persistent pain. The iCanCope with PainTM app is originally from Canada and based on theory, identified healthcare needs and current best practices for pain self-management. There was a need for ensuring the app was appropriate for a school-based population of Norwegian adolescents with persistent pain. Hence, Paper I described the translation and cultural adaptation of the app into the Norwegian context and evaluated the app’s usability. The findings from Paper I secured a fundamental platform for further feasibility testing on a larger scale. Given the limited research evidence regarding the underlying mechanisms between pain and HRQOL in adolescents with persistent pain, Paper II described the experience of pain, HRQOL and self-efficacy among this study sample; and explored the association between pain intensity and HRQOL testing for self-efficacy as a possible mediator. Finally, in Paper III we determined the feasibility and explored possible differences in outcomes between the intervention and control groups of an 8-week intervention using the Norwegian iCanCope with PainTM app. Two papers have been published in peer-reviewed journals and one paper submitted, which together have established a coherence in research toward the overall objective of this thesis.

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