Publications by authors named "Marit Hilsen"

8 Publications

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Health-related quality of life (HRQoL) in children of ill or substance abusing parents: examining factor structure and sub-group differences.

Qual Life Res 2019 Apr 26;28(4):1063-1073. Epub 2018 Nov 26.

Department for Research and Development, Mental Health Services, Akershus University Hospital, Box 1000, 1478, Lørenskog, Norway.

Purpose: Health-related quality of life (HRQoL) may be helpful in identifying children at risk of developing adjustment problems. Few studies have focused on HRQoL among children of ill or substance abusing parents despite their considerable risk status. In the present study, we used the KIDSCREEN-27 to assess self-reported HRQoL in children and adolescents living in families with parental illness, or substance dependence. First, we tested whether the factor structure of the KIDSCREEN-27 was replicated in this population of children. Next, we examined differences in HRQoL according to age, gender, and type of parental illness. Finally, we compared levels of HRQoL in our sample to a normative reference population.

Method: Two hundred and forty-six children and adolescents aged 8-17 years and their ill parents participated. The construct validity of the KIDSCREEN-27 questionnaire was examined by confirmatory factor analysis (CFA). T-tests and ANOVA were used to test differences in HRQoL levels according to age, gender, and parental patient groups, and for comparisons with reference population.

Results: The KIDSCREEN-27 fit the theoretical five-factor model of HRQoL reasonably well. Boys and younger children reported significantly greater well-being on physical well-being, psychological well-being, and peers and social support, compared to girls and older children. Younger children also reported significantly greater well-being at school than did older children. There were no significant differences in HRQoL between groups of children living with different type of parental illness. The children in our sample reported their physical well-being significantly lower than the reference population.

Conclusion: The KIDSCREEN-27 questionnaire appears to work satisfactorily among children of ill or substance abusing parents.
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http://dx.doi.org/10.1007/s11136-018-2067-1DOI Listing
April 2019

Predictors and mediators of differences in soft drinks consumption according to gender and plans of further education among Norwegian secondary-school children.

Public Health Nutr 2013 Jul 29;16(7):1250-6. Epub 2011 Nov 29.

Department of Public Health, Sport and Nutrition, Postboks 422, University of Agder, 4604 Kristiansand, Norway.

Objective: To explore mediators of gender and educational differences in sugarsweetened soft drinks consumption (SDC) and whether gender and level of future education moderate the associations of accessibility, modelling, attitudes and preferences with SDC.

Design: A cross-sectional school-based survey within the Fruits and Vegetables Makes the Marks (FVMM) project from 2005.

Setting: The questionnaires were completed by the pupils in the classroom guided by a trained project worker during one class session. The questionnaire included questions on SDC (times/week), the potential mediators and moderators. Multilevel linear regression models were used to calculate the mediating and moderating effects.

Subjects: A total of 2870 children in 9th and 10th grade (mean age 15?5 years) at thirty-three Norwegian secondary schools were included in the present study.

Results: Girls (B521?06) and pupils planning higher education (B520?69) reported lower frequency of SDC. The strongest mediators were accessibility and modelling for future educational plans differences (explaining alone respectively 69% and 44 %) and attitudes and preferences for gender differences (explaining were found, and all associations between the mediators and SDC were in the same direction for both genders and for those with and without plans of higher future education.

Conclusions: Preferences and modelling may contribute to gender and educational differences in SDC. The small moderating effects indicate that interventions aiming to reduce SDC can target the same mediators for boys and girls and children planning different levels of future education.
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http://dx.doi.org/10.1017/S1368980011002953DOI Listing
July 2013

Hormone therapy use and mammographic density in postmenopausal Norwegian women.

Breast Cancer Res Treat 2012 Feb 4;132(1):297-305. Epub 2011 Nov 4.

Department of Nutrition, University of Oslo, Oslo, Norway.

While studies have shown that use of postmenopausal hormone therapy with estrogen and progestogen (EPT) increases mammographic density, aspects of this association remain unclear. We examined whether mammographic density differed by type of hormone therapy (HT) used, dose, duration of use, time since last use, and whether the effects are modified by age and body mass index (BMI). Using a cross-sectional design, we recruited 2,424 postmenopausal women aged 50-69 years participating in the Norwegian Breast Cancer Screening Program. Mammographic density was assessed with a computer-assisted method, and we estimated mean absolute and percent mammographic density through multiple linear regression, and adjusting for possible confounders. Mammographic density was higher among current HT users (percent density: 22.6%; 95% CI: 22.1-23.2%) than among former (17.7%; 17.2-18.2%) or never users (16.3%; 15.7-16.8%). The highest density was seen in current EPT users of high-dose norethisterone acetate (NETA) regimens who had a percent density of 26.2% (24.3-28.1%). Results differed when considering the combined effect of age and BMI. The effect of EPT on mammographic density was modified by age and BMI, with no apparent association among the youngest women (aged 50-55) with the highest BMI (BMI ≥ 26). A higher mammographic density was found in EPT users compared to never HT users, particularly in women using high-dose NETA regimens. Age and BMI modified the association between EPT use and mammographic density.
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http://dx.doi.org/10.1007/s10549-011-1810-xDOI Listing
February 2012

Changes in 10-12 year old's fruit and vegetable intake in Norway from 2001 to 2008 in relation to gender and socioeconomic status - a comparison of two cross-sectional groups.

Int J Behav Nutr Phys Act 2011 Oct 3;8:108. Epub 2011 Oct 3.

Faculty of Health and Sport, University of Agder, Norway.

Background: Norwegian children and adolescents eat less than half of the recommended 5 portions of fruit and vegetables (FV) per day. Gender and socioeconomic disparities in FV consumption shows that boys and children of lower socioeconomic status (SES) eat less FV than girls and high SES children. We also know that accessibility and preferences has been identified as two important determinants of FV intake. The objectives of this study were to compare FV intake among Norwegian 6th and 7th graders in 2001 and 2008, to explore potential mediated effects of accessibility and preferences on changes in FV over time, to explore whether these changes in FV intake was moderated by gender and/or SES and whether a moderated effect in FV intake was mediated by accessibility and preferences of FV.

Methods: The baseline survey of the Fruits and Vegetables Make the Marks project was conducted in 2001 at 38 randomly chosen schools in two Norwegian counties. A second survey was conducted at the same schools in 2008. A total of 27 schools participated in both surveys (2001 n = 1488, 2008 n = 1339). FV intake was measured by four food frequency questions (times/week) in a questionnaire which the pupils completed at school. SES was based on parents' reports of their own educational level in a separate questionnaire. The main analyses were multilevel linear regression analyses.

Results: A significant year*parental educational level interaction was observed (p = 0.01). FV intake decreased among pupils of parents with lower educational level (13.9 vs. 12.6 times/week in 2001 and 2008, respectively), but increased among pupils of parents with higher education (14.8 vs. 15.0 times/week, respectively). This increasing SES disparity in FV intake was partly mediated by an increasing SES disparity in accessibility and preferences over time, wherein children with higher educated parents had a steeper increase in accessibility and preferences over time than children with lower educated parents. The year*sex interaction was not significant (p = 0.54).

Conclusions: This study shows an increase in SES disparities in 6th and 7th graders FV intake from 2001 to 2008, partly mediated by an increasing SES disparity in accessibility and preferences of FV.
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http://dx.doi.org/10.1186/1479-5868-8-108DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3195696PMC
October 2011

Mammographic density and intake of selected nutrients and vitamins in Norwegian women.

Nutr Cancer 2011 14;63(7):1011-20. Epub 2011 Sep 14.

Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.

Investigating the association between dietary factors and mammographic density (MD) could shed light on the relationship between diet and breast cancer risk. We took advantage of a national mammographic screening program to study the association between intake of nutrients and MD. In this study, we analyzed data of 2,252 postmenopausal women aged 50-69 yr who participated in the Norwegian Breast Cancer Screening Program in 2004. MD was assessed on digitized mammograms using a computer-assisted method. We used multivariate linear regression models to determine least square means of percent and absolute MD. Overall, we observed no associations between MD and intake of total calories, protein, carbohydrates, cholesterol, and dietary fiber. There was a positive borderline statistically significant association between absolute MD and total fat intake (P = 0.10) and between percent MD and intake of saturated fat (P = 0.06). There was no association between MD and intake of calcium, retinol, vitamins A, B12, C, or D, or combined intake of vitamin D and calcium. This study provides some evidence of an association between MD and dietary intake. Our study highlights the importance of adequate adjustments for BMI in studies of diet and MD.
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http://dx.doi.org/10.1080/01635581.2011.605983DOI Listing
February 2012

Healthy and unhealthy eating at lower secondary school in Norway.

Scand J Public Health 2010 Nov;38(5 Suppl):7-12

University of Agder, Kristiansand, Norway.

Aims: To assess adolescents' eating/drinking habits of a selection of healthy and unhealthy food items at school, variations in gender and socioeconomic status in these eating habits, and variations between the schools.

Methods: A cross-sectional study among 2870 adolescents (mean age: 15.5 years) within the Fruits and Vegetables Make the Marks (FVMM) project. A survey questionnaire was completed by the pupils in the classroom in the presence of a trained project worker. One school lesson (45 minutes) was used to complete the questionnaire. A total of two healthy (fruit and vegetables (FV), water) and five unhealthy (candy and/or potato chips, sweet bakery, instant noodles, regular soft drinks, and diet soft drinks) food items were assessed by food frequency questions. All variables were dichotomised to less than once a week and once a week or more.

Results: Several pupils reported to consume snacks (33%), sweet bakery (36%) and regular soft drinks (24%) at school at least once a week. The proportion of pupils who reported to eat FV at least once a week (40%) was low. Girls and pupils with plans of higher education had a more favourable intake of healthy versus unhealthy food items at school. In two-level variance component analyses the proportional school variation ranged from 3.4% (diet soft drinks) to 30.7% (noodles).

Conclusions: A large number of adolescents consume unhealthy food items at school and few eat FV. Large differences were observed between groups of pupils and between the schools in consumption of these foods.
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http://dx.doi.org/10.1177/1403494810376560DOI Listing
November 2010

Effect of the nationwide free school fruit scheme in Norway.

Br J Nutr 2010 Aug 30;104(4):589-94. Epub 2010 Mar 30.

Faculty of Health and Sport, University of Agder, Serviceboks 422, 4604 Kristiansand, Norway.

In Norway, children and adolescents consume only about half of the national five-a-day recommendation. There are also rather large social inequalities in health, and in eating behaviours. In order to increase fruit and vegetable (FV) intake, a subscription programme was initiated in 1996 and made nationwide in 2003, and a free programme (without parental payment) has been implemented nationwide from 2007. The objective of the present study is to evaluate the effect of these efforts. Pupils in the sixth and seventh grades (age 10-12 years) at twenty-seven schools responded to a questionnaire in 2001 (n 1488, 85 %) and in 2008 (n 1339, 78 %). FV intake was measured by a 24-h recall. In 2001, none of the schools had any organised school fruit programme. In 2008, five schools participated in the free school fruit programme, ten schools participated in the subscription programme and twelve schools did not participate in any official programme. The increases in fruit intake at school were 0.49, 0.29 and 0.18 portions/school day, respectively, for the Free Fruit 08, Subscription 08 and No Programme 08 schools (time x group P < 0.001), and 0.74, 0.39 and 0.16 portions/d for fruit intake all day (time x group P = 0.04). No group effect was observed for vegetable intake. There has been an increase in pupils' fruit intake from 2001 to 2008 in Norway, and the school fruit programmes seem to have been effective. A great challenge remains in increasing vegetable intake.
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http://dx.doi.org/10.1017/S0007114510000814DOI Listing
August 2010

The association between recreational physical activity and mammographic density.

Int J Cancer 2006 Oct;119(7):1695-701

Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA.

Physical activity has been associated with a reduced risk of breast cancer. However, little is known about the association between recreational physical activity and mammographic density. We examined the association between recreational physical activity and mammographic density using mammograms from 375 white and African American women without breast cancer who served as controls in the Los Angeles component of the Women's Contraceptive and Reproductive Experiences Study. We used data from 5 time periods of activity in the statistical analysis: from menarche to mammogram screening, the first 3 and 10 years after menarche, the most recent 10 years and the 3 years prior to mammogram screening. Lifetime history of recreational physical activity was obtained through interviews using a structured questionnaire. We used multiple linear regression to estimate least-squared mean values of absolute and percent mammographic density within categories of physical activity. Overall, we found no statistically significant evidence that physical activity reduced absolute or percent mammographic density. We observed a modest positive association between lifetime physical activity and percent mammographic density (p for trend = 0.04) among younger women, and between recent physical activity and percent density among both younger (<50 years, p for trend = 0.09) and older (> or =50 years, p for trend = 0.06) women, but these associations diminished after additionally adjusting for body mass index (BMI) (all p > or = 0.10). However, among women younger than 50 years, we found some evidence for a protective effect of "strenuous" physical activity in the first 3 years after menarche, with a nonstatistically significant inverse association with both absolute (p for trend = 0.07) and percent (p for trend = 0.08) mammographic density after adjustment for BMI. Our results suggest that physical activity is not a strong predictor of mammographic density.
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http://dx.doi.org/10.1002/ijc.22020DOI Listing
October 2006