Sammendrag
While social inequalities in health persist, a growing field of physical activity
research continues documenting the positive effects of physical activity on mental
and physical health. Hence, studies have suggested that there might be an association
between physical activity and socioeconomic status. However, public physical
activity interventions targeting low socioeconomic groups have shown limited
effects, and the associations between physical activity and socioeconomic status
seem more complex than previously assumed. Besides, recent research has given
reason to believe that there may be practices within the knowledge production in
physical activity research as such, that may cause incomplete knowledge about
how these variables relate.
The present thesis illuminates the implications of methodological practices within
physical activity research as explanations of the reported differences in physical
activity between socioeconomic groups. The main question is whether conventional
methodological choices affect the reported physical activity in socioeconomic groups
differently. In addition to traditional analyses of socioeconomic differences in aspects
of physical activity, Papers I-III study the impact of applying various
conceptualisations of physical activity, the impact of variations across instruments
for collecting physical activity data, and the generalisability of a controlled physical
activity intervention across socioeconomic groups, respectively.
The three studies included in the thesis employ different designs. The first paper is a
systematic article analysis of 56 previously published papers examining the
relationships between physical activity and socioeconomic status, aiming to
determine whether findings are linked only to the activity domain investigated, and
perhaps not total physical activity. Paper II has a cross-sectional design, applying
questionnaires, activity logs, and interviews among 52 breast cancer survivors to
uncover possible limitations in standard physical activity questionnaires. In Paper III,
we analyse adherence rates in a physical activity treatment intervention among 47
newly diagnosed breast cancer patients to identify socioeconomically (among other)
predictors.
The findings suggest that there is evidence for a positive relationship between
physical activity and socioeconomic status only for leisure-time physical activity. The
positive relationship between the mentioned variables is absent, or negative, in other
physical activity domains - especially within the occupational physical activity. In the
study of long-term breast cancer survivors, alternative methods assessing physical
activity, particularly time-geographic activity logs, reveal socioeconomic differences
in experiences from-, and routines for-, physical activity, without there necessarily
being different amounts of total physical activity. In the study of newly diagnosed
breast cancer survivors, we found a higher income among those who completed the
physical activity intervention comparing to those who withdrew, although there was
no significant association between socioeconomic status and adherence rate. A lack
of socioeconomic sample representativeness may, in part, explain the lack of
associations between adherence rates and socioeconomic status in our material.
The scientific understanding of the relationship between physical activity and
socioeconomic status seems to be largely based on exercise and leisure-time physical
activity data. The use of traditional questionnaires yields insufficient information
about differences in physical activity between socioeconomic groups. It is unclear
whether exercise interventions in breast cancer treatment are equally suitable to all
socioeconomic groups; however, they may risk excluding lower socioeconomic
groups and thus reduce the external validity.
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