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Background Various interventions have been developed with the intention to increase the amount of physical activity among children, including those promoting active school travel (AST). However, no gold standard currently exists for measuring different travel modes in AST. This study evaluates the criterion validity of a web-based data collection tool designed for children to self-report their school travel.

Purpose To assess the criterion validity of a web-based data collection tool for daily self-registration of commuting mode, time, and distance among middle school children in Sweden.

Methods Thirty children (10–12 years old) from six schools in Falun, Sweden, were recruited using snowball sampling. The children self-reported their school travel data for one day, including travel mode, commuting time, and distance. Their reports were compared to a criterion standard based on direct observations. Spearman correlation and the Wilcoxon signed-rank test were used to analyze the accuracy of the self-reported data.

Result The web-based data collection tool demonstrated 100% agreement between self-reported and observed travel modes, with high correlations for commuting time and distance (rs=0.953–0.989, p < 0.001). The Wilcoxon signed rank test showed no significant differences between self-reported data and criterion standard (p = 0.243–0.903).

Conclusion The strong agreement between self-reported and observed travel data indicates high criterion validity, suggesting that the web-based data collection tool is a reliable method for middle school children to self-report their daily school travel.

Background: Few children achieve the recommended daily levels of physical activity. Active school transportation (AST) offers a valuable opportunity to increase children’s physical activity. Initiatives promoting AST in early childhood are important and have the potential to reverse the decline in physical activity.

Objective: This study protocol outlines an age-cohort design to evaluate the effectiveness of the Sustainable Innovation for Children Transporting Actively (SICTA) intervention on children’s AST.

Methods: SICTA is a 4-week school-based intervention that incorporates gamification elements to enhance motivation and aims to increase AST in children. The intervention involves children and their parents as gatekeepers, as well as teachers delivering the intervention. All children, parents, and teachers in all schools, from grades 4 to 6 in one municipality in the southern part of Sweden, will be invited to participate in the evaluation. Following the age-cohort design, students at baseline (late fall 2024) will be compared with students of the same age from the same schools 1 year later at follow-up (late fall 2025) after receiving the intervention (implemented in late fall 2025). Using questionnaires at baseline and follow-up, this study will examine the effects of the intervention on children’s levels of AST. Children’s independent mobility and several mediators related to AST in both children and parents, based on the theory of planned behavior, the transtheoretical model of change, and self-determination theory, will also be examined. The intervention will also be evaluated from a sustainable perspective using the sustainable value equation. At follow-up, data collection will include a questionnaire for teachers assessing the feasibility of the intervention.

Results: The project is funded for the period 2024-2026, and follow-up data collection is ongoing following completion of the intervention in late fall 2025. Results will be reported according to the predefined outcomes, including changes in AST, children’s independent mobility, psychosocial determinants among children and parents, and sustainability outcomes, as well as feasibility.

Conclusions: The findings are expected to provide valuable insights into the effectiveness of the SICTA intervention, facilitating knowledge dissemination among end users and policymakers.

Coronavirus disease 2019 (COVID-19) is a respiratory illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Health-related quality of life (HRQoL) has been observed to decline after COVID-19 hospitalization, with anxiety and depression contributing to reduced HRQoL and emphasizing the need for research on long-term outcomes. The aim of the study was to longitudinally explore self-reported symptoms of anxiety, depression, and associated factors of HRQoL during 2 years after hospital-treated COVID-19, and to compare differences based on age, sex, and initial disease severity. Participants were included from the Life in the Time of COVID study in Gothenburg, comprising individuals hospitalized with COVID-19 during the first and second waves of the pandemic in Sweden. This prospective study includes follow-ups at 3 months, 1 year, and 2 years after discharge, using patient-reported outcomes assessing symptoms of anxiety, depression, HRQoL, and clinical data. The study comprised 125 participants, of whom 111 were eligible for longitudinal analysis. Two years after COVID-19, individuals with initial moderate infection reported higher levels of anxiety (p = 0.031) and pain/discomfort (p = 0.039) than did those with severe infection. Symptoms of anxiety did not change significantly over the study period. Depressive symptoms increased significantly between 3 and 12 months after COVID-19 (Z = − 2.957, p = 0.003). Older age was significantly associated with lower HRQoL (B = − 0.003, 95% CI [–0.004, − 0.001], p = 0.010). Symptoms of anxiety remained generally within the normal range throughout the two-year follow-up after hospital-treated COVID-19. Symptoms of depression were lower at 3 months after hospitalization but subsequently stabilized at a higher, yet still normal, level. At two years after COVID-19, lower HRQoL was associated with older age, highlighting the importance of addressing age-related vulnerabilities in long-term follow-up care.

Background: Physiotherapy education is increasingly expected to contribute to sustainable development within planetary boundaries. Yet little is known about how educators themselves understand and approach this task within undergraduate programs. Exploring educators’ perspectives is essential for informing the development of meaningful and profession‑specific approaches to education for sustainable development. The aim of this study was to describe physiotherapy educators’ perceptions of education for sustainable development within undergraduate programs in Sweden. Method: Eighteen educators from five undergraduate physiotherapy programs participated in semi-structured interviews. Data was analysed using reflexive thematic analysis. The participants were selected to represent educators from both campus and clinical practice, both sexes, different ages, varied educational and professional positions, and varying experiences with education for sustainable development. Result: Five themes describe the educators’ perspectives on education for sustainable development: ‘Strengthening the profession through collective global responsibility’; ‘Promoting sustainable health and responsible practice’; ‘Broadening perspectives and deepening professional engagement’; ‘Embedding sustainability as a lived and integrated curriculum experience’; ‘Balancing top-down direction with professional autonomy and growth’. Conclusion: Physiotherapy educators in Sweden perceive education for sustainable development as a meaningful yet still unsettled dimension of physiotherapy education. While shaped by a sense of global responsibility, it is primarily understood and emphasised through efficiency and prevention as key professional contributions, with limited attention to broader ethical and planetary health perspectives. Strengthened profession-specific conceptual understanding and institutional support, aligned with professional development, may be important for embedding sustainable development as an integrated dimension of physiotherapy education. © 2026 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Empirical studies evaluating stroke team rehabilitation interventions from a sustainability perspective are scarce. This paper highlights the significant role of multidisciplinary stroke team rehabilitation in promoting sustainable healthcare by applying principles of sustainable healthcare. Climate change and air pollution are significant risk factors for stroke and other cardiovascular diseases. Healthcare contributes to 5% of global CO2 emissions, exacerbating the disease burden associated with climate change. The vulnerability of individuals with disabilities to climate change has been highlighted, calling for global collaboration to address climate justice and health equity. This paper argues that multidisciplinary stroke team rehabilitation is essential for achieving sustainable stroke care, optimizing patient functioning, and contributing to all principles of sustainable healthcare: prevention, patient empowerment, lean pathways, low carbon alternatives, and efficient resource use. Timely assessments and dose-specific interventions are crucial for successful outcomes, providing significant co-benefits for healthcare resource use. Enhancing self-management and patient empowerment reduces healthcare utilization without compromising health outcomes. Telerehabilitation increases accessibility to healthcare services, particularly where transportation is challenging, and complements hospital-based procedures. Preventive healthcare activities, with their low carbon footprint, offer strong incentives for optimizing secondary prevention in stroke. Overall, multidisciplinary stroke team rehabilitation aligns with all sustainable healthcare principles, reducing overall healthcare consumption through optimized functioning and health. Increased investment in rehabilitation resources leads to better quality of care and reduced long-term resource use. By integrating sustainable practices, stroke team rehabilitation can significantly contribute to sustainable healthcare, addressing both human and planetary health. Copyright © 2025 Persson, Reinholdsson, Lange, Barna and Palstam.

BACKGROUND: A wide range of school interventions have been launched to increase childrens' physical activity. Evaluation of the effectiveness of interventions requires suitable study designs and feasible quantitative evaluations relating to the school setting. The purpose of this study was to assess the evaluation design and methods for data collection, in order to make decisions about approaching forthcoming studies of the effectiveness of active school travel (AST) interventions.

METHODS: Children from four Swedish schools in fifth grade (11-12 years old) participated in this non-randomized pilot study, two schools received an AST intervention and two schools were controls. The school-based AST intervention Sustainable Innovation for Children Transporting Actively (SICTA) was conducted by teachers in the classroom setting during four weeks. To assess feasibility of the evaluation design and methods for data collection a combination of quantitative and qualitative methods were applied, using participation- and response rates, a feasibility questionnaire and focus group interviews.

RESULTS: Out of 25 potential schools, four schools accepted participation with explicit allocation requests preventing randomization. Out of 181 children, 107 children (59%) accepted participation. A total of 82% of the participating children reported active travel before the AST intervention, and 80% found reporting of daily school travels in the web-based survey to be easy. The children were in general positive about participating in the study and the methods for data collection were considered easy for the participating children to conduct and to blend well with usual school activities. There was an imbalance in reporting rates between intervention and control schools as well as a decrease in reporting rates during the study period.

CONCLUSIONS: Our results highlight the complexity and challenges in conducting controlled research among school children. Although children were positive about participation and found reporting to be easy, our results invoke the need to use alternative research designs and recruitment strategies that also attract children using non-active modes of travel when evaluating AST interventions in school contexts.

TRIAL REGISTRATION: The study is registered 2023/11/02 with Researchweb, the Swedish Register for Research with registration number 281,543. The registration can be reached via this link: https://www.researchweb.org/is/sverige/project/281543 .

There is an urgent need for a global shift toward more sustainable living. Electric vehicles contribute to this goal; however, the transition is challenging, particularly due to high purchase costs, which can be a particular hindrance for people with disabilities. Only a few individuals currently drive electric vehicles with necessary adaptations, and the insights and experiences of these early adopters can offer valuable knowledge. The aim of this study is to explore the motives and initial experiences of Swedish persons who drive electric vehicles with car adaptations. Semi-structured interviews were conducted among nine people living with physical impairments who drove an electric car with adaptations. The data were analyzed using content analysis. The motives for shifting from fossil-fuel vehicles to electric vehicles included long-term economic benefits, environmental aspects, practical advantages, and interest in new technologies and cars. Interviewees generally found it easy to adapt to their new electric vehicles, although some needed to establish new routines for charging during longdistance trips. Participants highlighted functional advantages-such as remote heating, and spacious interiors-as particularly beneficial for their needs. Home charging was perceived as a major enabler of independent mobility, while limited accessibility at public charging stations and insufficient financial support posed challenges. Despite these barriers, the perceived benefits of electric vehicle ownership predominated. These findings highlight the need for inclusive infrastructure and revised policy frameworks to ensure that individuals with physical impairments can fully participate in the transition to fossil-free mobility.

OBJECTIVE: To identify factors, present at 3 months after COVID-19 that are associated with the level of functioning 1 year after hospitalization.

DESIGN: Multicenter prospective observational study.

SETTING: Region Västra Götaland Sweden.

PARTICIPANTS: Patients ≥ 18 years of age who were followed regarding body functions and activities 3 months and 1 year after discharge from a hospitalization for COVID-19.

MAIN MEASURES: Patient-reported outcome measures at 3 months and 1 year, a clinical follow-up at 1 year, and clinical information retrieved from medical charts.

RESULTS: In total 169 participants were included in the analysis, including 113 males (67%). The mean patient age was 66 (standard deviation (SD) 13, range 21-95). One year after hospitalization, 50 (34%) participants were under the normative value for forced vital capacity and 57 (39%) were under normative value for forced expiratory volume in 1 second. The mean walking distance was 441 m (SD 118 m) in the 6-minute walking test, and 62 (40%) patients reported mobility problems. Older age, female sex, and more self-reported symptoms of physical fatigue were significantly associated with lower levels of functioning 1 year after COVID-19. The initial severity of COVID-19 did not significantly influence functioning at 1 year.

CONCLUSION: Previously hospitalized individuals with respiratory difficulties 1 year after COVID-19 may present acceptable lung function on spirometry but be close to their maximal functional performance. The findings highlight the need for in-depth assessments to identify rehabilitation needs.

Active school travel (AST) is an effective approach for increasing children's physical activity and independent mobility, but policy supporting AST is lacking. This study aims to explore children's experiences of AST to inform a policy recommendation. Photovoice methodology with a qualitative approach was applied, with children taking pictures on their way to school. This was followed by focus groups where the children explored their experiences of AST based on their photos. The data were analyzed using qualitative content analysis. The results show that the children valued independent mobility and wanted to be involved in decisions about their travels; they also expressed feelings of increased responsibility and personal growth as a consequence. Although the children recognized areas of improvement regarding infrastructure, especially regarding heavy traffic that jeopardized travel safety, they continued using AST. Finally, the children talked about the value of the health and environmental benefits of AST. Opportunities for friendship, play, and making decisions about their own time were highlighted as important incentives. The benefits from AST are many for children, as well as for society. The result has informed policy recommendations for AST, and the children's input will be used to communicate the recommendations. Listening to the voices of children could be a steppingstone toward forming future healthy mobility initiatives. In that process, it is key to include children's perspectives when formulating the AST policy for successful adoption and implementation.