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Introduction
Heidi Klakk currently works at the Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark. Heidi does research in Sports Medicine, ChildHealth and Exercise Epidemiology . Their current project is 'Childhood Health, Activity, and Motor Performance School Study Denmark (CHAMPS-study DK) and SCREENS - a study in screen media use and health .
Heidi Klakk is also assistant professor at University College Lillebælt where childhood health and teaching science for health professionals are her key competences.
Publications
Publications (79)
This study aimed to estimate the effects of an intensive school-based physical education intervention on the risk of developing overweight or obesity in primary school students when accounting for the moderating role of socioeconomic status. This quasi-experimental trial included data from primary school students participating in an intensive physi...
Background
Fishers are at risk of back disorders due to their physically demanding work. The aim was to investigate risk factors for back disorders in fishers in Denmark.
Methods
All male Danish registered fishers between 1994 and 2017 were included. ICD-10 codes classified back disorders (M40-M54* and DM99.1-4*). A multistate model on a cause-spe...
Objectives
A new school policy mandating 45 min physical activity daily during school was introduced in Denmark in 2014. We aimed to evaluate the effect of this policy on BMI in school-aged children. It was hypothesized that the school policy would decrease BMI, especially in the obese fraction of the population (90th percentile BMI).
Study design...
Background
To fully implement the internationally acknowledged requirements for teaching in evidence-based practice, and support the student’s development of core competencies in evidence-based practice, educators at professional bachelor degree programs in healthcare need a systematic overview of evidence-based teaching and learning interventions....
As smartphone addiction has been linked to poor mental health and lower levels of physical activity, it is of public health interest to explore the behavior behind problematic smartphone use and develop interventions to reduce smartphone use. This study aimed to investigate the risk of smartphone addiction and examine perceived problematic smartpho...
Background:
To fully implement the internationally acknowledged requirements for teaching in evidence-based practice, and support the student’s development of core competencies in evidence-based practice, educators at professional bachelor degree programs in healthcare needs a systematic overview of evidence-based teaching and learning intervention...
Objective:
To identify and describe occupational and physiotherapy rehabilitation modalities used to support an interdisciplinary rehabilitation in adults (aged 16 + years) with concussion.
Methods:
A scoping review methodology was used. Included studies were categorized according to Wade's elements of rehabilitation and the Danish White Paper d...
Sports participation has potential to promote physical activity in youth. Unfortunately, sports participation and physical activity may decline from childhood to adolescence and into adulthood. Globally, only 20% of 13–15-year-olds meet the World Health Organisation recommendations for physical activity. This study aimed to investigate the 5-year t...
Background
The prevalence of musculoskeletal disorders (MSDs) among occupational fishers is high, yet knowledge of the risk factors is scarce and inconsistent. The aim of this study was to investigate the risk from various work-related characteristics on incident hospital contact due to a musculoskeletal disorders and other pain disorders among Dan...
BACKGROUND: Children spend increasing amounts of time on recreational screen media, which may lead to an obesogenic environment.
OBJECTIVES: We investigated the association of trajectories of screen time across ages 3, 5 and 7 years with body composition at age 7 in the Odense Child Cohort. METHODS: Data were collected in the Municipality of Odense...
Objective
This study aimed to investigate the association of parental recreational screen media practices, including time use and level of smartphone addiction, with behavioral difficulties in 7-year-old children.
Methods
The study was based on cross-sectional data from The Odense Child Cohort, a community-based birth-cohort study. A total of 1,15...
Background: The prevalence of musculoskeletal disorders (MSDs) among occupational fishers is high, yet knowledge of the risk factors is scarce and inconsistent. This study investigated the risk of first hospital contact due to MSDs among occupational fishers, taking period effect into account.
Methods: This register-based study comprised data from...
Schools have been identified as a promising setting for promoting physical activity (PA). Yet, to realize changes at the population level, successful school-based PA programs need to go to scale. The Svendborgproject is an effective school-based program promoting additional physical education (PE) lessons. The aim of this study is to determine prog...
Background
In breast cancer patients, late-term upper limb sequelae, such as shoulder pain and impaired shoulder function, remain common after primary breast cancer surgery. The aim of this trial is to evaluate whether an expert assessment of shoulder impairments, followed by an individualised treatment plan, is superior to a minimal physiotherapeu...
Context:
There is a rise in overweight and obesity among children and adolescents with type 1 diabetes (T1D) in parallel with the rise in the metabolic syndrome (MetS) among children and adolescents.
Objective:
The aim of the study was to describe the prevalence and characteristics of MetS in children and adolescents with T1D compared to their h...
The COVID-19 pandemic and the concomitant infodemic have emphasized the importance of digital health literacy (DHL) to global public health research and practice. The aim of this study was to examine information-seeking behavior, the ability to find, understand and deal with health information among university college students in Denmark and/in add...
The COVID-19 pandemic and the concomitant infodemic have emphasized the importance of digital health literacy (DHL) to global public health research and practice. The aim of this study was to examine information-seeking behavior, the ability to find, understand and deal with health information among university college students in Denmark and/in add...
The COVID-19 pandemic and the concomitant infodemic have emphasized the importance of digital health literacy (DHL) to global public health research and practice. The aim of this study was to examine information-seeking behavior, the ability to find, understand and deal with health information among university college students in Denmark and/in add...
The COVID-19 pandemic and the concomitant infodemic have emphasized the importance of digital health literacy (DHL) to global public health research and practice. The aim of this study was to examine information-seeking behavior, the ability to find, understand and deal with health information among university college students in Denmark and/in add...
Screen media use is part of most children's everyday lives, but organisations have advised that use should be limited. The aims of this study were to describe 6–11-year-old Danish children's screen device ownership and screen media use (weekdays and weekends), including the role of parental education, family structure and household screen media rul...
This study evaluated the criterion validity of a newly developed application for assessing smartphone use on iOS and Android based devices. A sample of adult Danes (n=40; 40% female; median age= 42.0 years) had the application SDU DeviceTracker installed on their mobile phone together with a commercial application that served as a reference for com...
Physical activity (PA) is critical to improving health factors such as weight, adiposity, and aerobic fitness. However, children who meet PA guideline recommendations demonstrate developmental differences in health-related outcomes. To investigate prospective associations between PA behaviour (overall PA and PA intensity) and trajectories of health...
Background
Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories.
Methods
We used data from 1990 to 2019 on people aged 30...
From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in di...
From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in di...
Objectives
Describe the trajectories of body mass index (BMI), waist circumference, and aerobic fitness in children and identify different outcomes of guideline-recommended physical activity (PA) in a subset of active children.Methods
We recruited students from 10 public primary schools and obtained repeated measures of BMI, waist circumference, an...
Background
Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents.
Methods
For this pooled ana...
Background:
The screen-media landscape has changed drastically during the last decade with wide-scale ownership and use of new portable touchscreen-based devices plausibly causing changes in the volume of screen media use and the way children and young people entertain themselves and communicate with friends and family members. This rapid developm...
Background:
During the recent decade presence of digital media, especially handheld devices, in everyday life, has been increasing. Survey data suggests that children and adults spend much of their leisure on screen media, including use of social media and video services. Despite much public debate on possible harmful effects of such behavioral sh...
Background: The screen-media landscape has changed drastically during the last decade with wide-scale ownership and use of new portable touchscreen-based devices plausibly causing changes in the volume of screen media use and the way children and young people entertain themselves and communicate with friends and family members. This rapid developme...
Background: The screen-media landscape has changed drastically during the last decade with wide-scale ownership and use of new portable touchscreen-based devices plausibly causing changes in the volume of screen media use and the way children and young people entertain themselves and communicate with friends and family members. This rapid developme...
Background: The screen-media landscape has changed drastically during the last decade with wide-scale ownership and use of new portable touchscreen-based devices plausibly causing changes in the volume of screen media use and the way children and young people entertain themselves and communicate with friends and family members. This rapid developme...
Evidence suggests that motor performance in children is declining globally. We tested whether participation in organized sport is associated with motor performance, and estimate the effect of 30 months participation in organized sport on motor performance. Study participants were 1067 primary school students, enrolled in the Danish Childhood Health...
Purpose
To examine the prospective associations between spinal pain exposures and risk factors for cardiovascular disease in children and explore the mediating role of health-related physical activity.
Methods
Students were recruited from ten public primary schools. Each week from November 2008 to October 2010, parents reported spinal pain occurre...
Background:
School-based physical education (PE) and organised leisure-time sports participation (LTSP) represent important physical activity opportunities for children. We examined the preventive effect of increased PE as well as LTSP on overweight and obesity (OW/OB) in school children.
Methods:
Longitudinal data from children attending 10 pri...
Aim:
We evaluated the effect that increasing physical education lessons from 1.5 to 4.5 hours per week for five years had on the body mass index (BMI) and waist circumferences of children aged 5-11 years at inclusion.
Methods:
From 2008-2013, six intervention schools in Svendborg, Denmark, delivered 4.5 hours of physical education lessons per we...
There is an ongoing need for research focusing on how to implement physical activity programmes into a school setting. This includes documentation of the extent to which programmes are compatible with the basic views of providers and their local practices. The present study explores the Svendborgproject – a programme tripling the amount of physical...
Background:
The role of muscle fitness in controlling cardiometabolic risk factors during childhood is incompletely understood.
Methods:
A prospective observational design including 6- to 11-year-old children (n = 512) was used to study associations between 1.5-year changes in handgrip strength, standing vertical jump displacement, the short shu...
Background/objectives:
Examine the prospective relationship of total volume versus bouts of sedentary behaviour (SB) and moderate-to-vigorous physical activity (MVPA) with cardiometabolic risk in children. In addition, the moderating effects of weight status and MVPA were explored.
Subjects/methods:
Longitudinal study including 454 primary schoo...
Documenting the implementation of effective real-world programmes is considered an important step to support the translation of evidence into practice. Thus, the aim of this study was to identify factors influencing the adoption, implementation and maintenance of the Svendborgproject (SP) - an effective real-world programme comprising schools to im...
Schools constitute an important arena for promoting physical activity. However, school-based programmes often face implementation challenges, and the identification of factors influencing the implementation process is considered important in order to secure the effectiveness of future interventions. The aim of this study was to identify factors inf...
Background: Schools are a key setting for large-scale primordial non-communicable disease prevention in young
people, but little data on sustainability of impacts on cardiometabolic risk markers is available.
Methods: Six and a half year follow-up of a natural experiment. In 2008, six public schools in the municipality of
Svendborg (Denmark) augmen...
To examine the association between insulin sensitivity and adiposity in children stratified according to their body mass index (BMI: normal weight, NW; overweight or obese, OW/OB) and body-fat percentage (BF%: adipose or NonAdipose), and determine whether cardiorespiratory fitness (CRF) ameliorates any deleterious associations.
This prospective coh...
Depression in young adults is a growing concern to public health. This study aims to investigate if depression status in young adults is related to clinical and behavioral cardiovascular disease (CVD) risk factors. Cross-sectional data from a population-based sample of young Danish adults participating in the European Youth Heart Study 2009–2010 we...
Aim:
To investigate the influence of a school-based intervention with a tripling of physical education (PE) lessons from two (90 min) to six lessons per week (270 min) on scholastic performance.
Methods:
This study is part of the CHAMPS study-DK, a quasi-experimental study that began in 2008. The intervention group consisted of six schools and t...
Objective
To investigate the prospective association of organized leisure-time sports participation with cardiovascular risk in children.
Methods
Students were recruited from 10 public primary schools. From July 2009 to October 2010, parents reported children's weekly organized leisure-time sports participation via text messaging. Clustered cardio...
Purpose:
High levels of cardiorespiratory fitness (CRF) may attenuate the association between excessive adiposity and the risks of cardiovascular and metabolic disease. The purpose of this study was to stratify children according to their BMI and adiposity (body fat percentage, BF%) and compare levels of CRF across subgroups.
Methods:
This prosp...
Overweight, physical inactivity and sedentary behaviour have become increasing problems during the past decade. Increased sedentary behaviour may change the body composition (BC) by increasing the fat mass relative to the lean mass (LM). These changes may influence bone health to describe how anthropometry and BC predict the development of the bone...
Background
Primarily, this study aims to examine whether children attending sports schools are more active than their counterpart attending normal schools. Secondary, the study aims to examine if physical activity (PA) levels in specific domains differ across school types. Finally, potential modifications by status of overweight/obesity and poor ca...
First, this study aimed to investigate if four extra physical education (PE) lessons per week improved children's development in physical fitness. Second, to investigate if the extra PE lessons improved development in physical fitness for children with lower levels of fitness at baseline. This study was a longitudinal controlled school-based study....
Injuries sustained in sports and leisure time has been established as a leading cause of the paediatric injury burden in western countries. Injuries reported are mostly traumatic, but there is a growing concern about overuse injuries in children.
The objectives of this prospective cohort study were to report the incidence, prevalence and duration o...
This study aimed to examine the prospective association of three different measures of adiposity and cardiorespiratory fitness (CRF) with 2-year change in cardiovascular disease (CVD) risk factors in children. Two-year longitudinal data in schoolchildren aged 7-11 years (n = 365-729) was used. Total body fat (TBF) from dual-energy x-ray absorptiome...
Overweight youths are generally recognised as being at increased risk of sustaining lower extremity injuries in sports. However, previous studies are inconclusive and choices for measuring overweight are manifold.
To examine two different measures of overweight, body mass index (BMI) and total body fat percentage (TBF%), as risk factors for lower l...
Strategies for combating increasing childhood obesity is called for. School settings have been pointed out as potentially effective settings for prevention. The objective of this paper was to evaluate the effect of four additional Physical Education (PE) lessons/week in primary schools on body composition and weight status in children aged 8--13.
C...
Aims:
Cardiovascular disease (CVD) originates during childhood and adolescence. Schools are potentially effective settings for early public health prevention strategies. The aim of this study was to evaluate the effect of six physical education (PE) lessons on children's CVD risk.
Methods:
This longitudinal study in 10 public schools (1218 child...
The objectives of this prospective cohort study were to report the incidence, prevalence, and duration of traumatic and overuse injuries during a period of 2.5 years and to estimate the odds of injury types. In all, 1259 schoolchildren, aged 6-12, were surveyed each week with an automated mobile phone text message asking questions on the presence o...
Adiposity, physical inactivity and sedentary behavior have become an increasing problem during the past decade and raise concerns about future health. Increased sedentary behavior may change the body composition by increasing the fat mass (FM) relative to the lean mass (LM). These changes may influence bone health. This study aimed at evaluating th...
Background
Studies indicate genetic and lifestyle factors can contribute to optimal bone development. In particular, the intensity level of physical activity may have an impact on bone health. This study aims to assess the relationship between physical activity at different intensities and Bone Mineral Content (BMC), Bone Mineral Density (BMD) and...
Background
An increasingly passive life-style in the Western World has led to a rise in life-style related disorders. This is a major concern for all segments of society. The county council of the municipality of Svendborg in Denmark, created six Sport Schools with increased levels of suitable physical activities, which made it possible to study th...