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Sökning: margareta rämgård > Carlson Elisabeth

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1.
  • Ramji, Rathi, et al. (författare)
  • Health and quality of life among women after participation in a CBPR-informed physical activity intervention : with a pandemic perspective.
  • 2023
  • Ingår i: Scientific Reports. - : Springer Nature. - 2045-2322. ; 13:1
  • Tidskriftsartikel (refereegranskat)abstract
    • The lack of culturally and contextually oriented interventions promoting physical activity (PA) has led to increased physical inactivity among women living in disadvantaged neighbourhoods in Sweden. In this study one such intervention informed by community-based participatory research (CBPR) has been evaluated among 34 women from a disadvantaged neighbourhood before and during COVID-19. Health-related quality of life (HRQOL), behavioural and biomedical outcomes were assessed directly prior and post-intervention, followed by evaluations at 6-months and 18-months follow-up during COVID-19. The results revealed that HRQOL, particularly psychological, social, and environmental health significantly increased post-intervention compared to prior to intervention but reversed back at 6-months follow-up. Perceived health satisfaction and environmental health increased at 18-months follow-up during COVID-19. Participation in PA improved post-intervention and at 6-months follow-up. Everyday activities and fruit and vegetable intake continued to increase through all timepoints. Systolic blood pressure significantly decreased post-intervention and 6-months follow-up; blood flow rate increased significantly at all timepoints. Overall, the findings underscores the potential effectiveness of CBPR approaches in promoting and sustaining healthy lifestyles, even during acute situations such as the COVID-19. It may even serve as a future model for promoting health and addressing health disparities in similar groups.
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2.
  • Ramji, Rathi (författare)
  • Health promotional interventions informed by community-based participatory research in a socially disadvantaged neighbourhood : development, exploration and evaluation
  • 2022
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The overall aim of this thesis was to understand the impact of community-based participatory research-informed health promotional initiatives on the health of communities living in socially disadvantaged neighbourhoods in Southern Sweden. The thesis was part of a larger program, Health promotion, Innovation in Collaboration which was a community-based participatory research program aiming to create novel ways to improve health through participatory and collaborative strategies. The thesis embraces one mixed-method study, a quantitative study, a qualitative study and finally a participatory action research study with a qualitative approach. A total of 49 citizens and 10 families with children aged 7-14 years from a disadvantaged neighbourhood in Southern Sweden participated in the different studies. The mixed-method study (Study I) described the development of initial evaluation of a Community-based participatory research(CBPR) informed physical activity intervention, which showed the need for the intervention to be offered cost-free and exclusively for women. In line with the results of the first study, the CBPR physical activity intervention was offered to 35 women in the neighbourhood and the effect of the intervention was assessed over time both quantitatively (Study II) and qualitatively (Study III), including a perspective on the pandemic. The last study (Study IV) focused on diet and oral health among families, particularly mothers and children. In this study, the children were initially engaged in a photovoice interview which was followed by a focus group with parents. The pre-study revealed that children disliked school lunch and did not eat breakfast regularly owing to time constraints and family situations. Furthermore, children also consumed a high amount of sugar. To this, the parents expressed that they were not able to guide their children appropriately and needed help with aspects such as diet focusing on breakfast, lunch and dinner, as well as knowledge on oral hygiene habits. The quantitative part of Study I and Study II were repeated measures data at different time points before and after the intervention. The qualitative data in studies I and III were collected in form of focus group interviews in parallel to the quantitative data. The mode of data collection in Study IV was Multi-staged focus groups where the same families met at different time points and engaged in dialogue and reflection on different topics at each meeting. The results of the first three studies show that a CBPR informed physical activity intervention when offered in groups improved health-related quality of life, physical health, induced behavioural change and potentially builds resilience to withstand the psychosocial and physical effects of the pandemic. The last study shows that a CBPR informed oral health promotion through reflection and dialogue among families together with other stakeholders, influences behavioural change and perceived changes in health among parents and children living in a disadvantaged neighbourhood. In conclusion, this thesis highlights that social support is key to improved perceived health, empowerment, and sustainable behavioural change among citizens in the neighbourhood. Although women are most in need of support, they are also gateways to the families and thereby their communities. And finally, health promoters have had a vital role in engaging communities in health promotional efforts and bringing them closer to other societal actors, strengthening their social bonds and helping build community resilience in the face of adversity.
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3.
  • Ramji, Rathi, et al. (författare)
  • Impact of a CBPR-informed physical activity intervention before and during COVID-19 among women from a disadvantaged neighborhood in Sweden.
  • 2022
  • Ingår i: Frontiers In Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 10
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Public health practitioners have been striving to reduce the social gradient and promote physical activity among citizens living in disadvantaged neighborhoods. The emergence of the COVID-19 pandemic, which has affected these citizens extensively, has posed a significant challenge to efforts to maintain a physically active lifestyle. Thus, the aim of this study was to explore the impact of a CBPR-informed physical activity intervention before and during the COVID-19 pandemic from the perspective of women from a socially disadvantaged neighborhood.METHODS: A total of 34 women participated in a CBPR-informed physical activity intervention previously developed in collaboration with lay health promoters and other citizens from the same neighborhood. Focus group discussions were conducted at four time points, namely, at baseline prior to the intervention, post-intervention, 6 months after the intervention ended, and during the COVID-19 pandemic. The data were analyzed using qualitative content analysis following an inductive approach.RESULTS: In total, four themes emerged from the discussions: "Wavering between frustration and action," "Shifting from prioritizing family needs to taking control of self," "Between isolation and social support," and "Restricted access to health-related knowledge vs. utilizing internalized knowledge".CONCLUSION: The results of this study reveal that building on CBPR-informed health promotion initiatives has the potential to foster individual empowerment and assist during acute situations like the COVID-19 pandemic through mobilizing communities and their resources, which leads to increased community resilience and health. This study is regarded as unique in that it involves evaluation of a CBPR intervention that was initiated ahead of the pandemic and followed even during the pandemic.
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4.
  • Ramji, Rathi, et al. (författare)
  • Development and evaluation of a physical activity intervention informed by participatory research : a feasibility study
  • 2020
  • Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 20
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Despite numerous interventions aiming to improve physical activity in socially disadvantagedpopulations, physical inactivity remains to be a rising challenge to public health globally, as well as, in Sweden. Inan effort to address this challenge, a community-based participatory intervention was developed through activecommunity engagement and implemented in a socially disadvantaged neighborhood in Sweden. The current studyaims to present the development and initial evaluation of a participatory research driven physical activityintervention.Methods: Fifteen participants (11 females and 4 males) aged 17–59 years volunteered to participate in the physicalactivity intervention program. The intervention program was evaluated using a longitudinal mixed methods designmeasuring health impact changes over time through focus group discussions and quality of life surveys. Furtheradditional biomedical health parameters such as levels of glycosylated hemoglobin, blood pressure, levels ofoxygen saturation and body mass index were monitored before and after the intervention. Focus group data wereanalyzed using content analysis with an inductive approach. The pre-and post-test scores from the survey-basedquality of life domains, as well as the health parameters were compared using non-parametric and parametricstatistics.Results: Four themes emerged from the analysis of the focus group discussions including sense of fellowship,striving for inclusion and equity, changing the learner perspective and health beyond illness. The scores for thedomains Physical Health, Psychological Health, Social Relationships and Health Satisfaction where significantlyhigher after participation in the physical activity intervention program compared to the pre-test scores (p < .05)s.There were however, no significant changes in the scores for the environmental domain and overall quality of lifeafter intervention compared to that prior to intervention start. Overall, the biomedical health parameters remainedstable within the normal ranges during intervention.Conclusion: The focus group discussions and results from the surveys and biomedical measures reveal importantfindings to understand and further develop the intervention program to promote health equity among citizens indisadvantaged areas. Evaluating the feasibility of such an intervention using multiple approaches contributes toeffective implementation of it for larger communities in need.
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5.
  • Ramji, Rathi, et al. (författare)
  • Understanding behavioural changes through community-based participatory research to promote oral health in socially disadvantaged neighbourhoods in Southern Sweden.
  • 2020
  • Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 10:4
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: Inequalities in oral health have been on the rise globally. In Sweden, these differences exist not between regions, but among subgroups living in vulnerable situations. This study aims at understanding behavioural change after taking part in participatory oral health promotional activity among families living in socially disadvantaged neighbourhoods in Southern Sweden.SETTING: The current study involved citizens from a socially disadvantaged neighbourhood in Malmö, together with actors from the academic, public and private sectors. These neighbourhoods were characterised by high rates of unemployment, crime, low education levels and, most importantly, poor health.PARTICIPANTS: Families with children aged 7-14 years from the neighbourhood were invited to participate in the health promotional activities by a community representative, known as a health promoter, using snowball sampling. Between 8 and 12 families participated in the multistage focus groups over 6 months. Data were analysed using qualitative content analysis.RESULTS: Three main themes emerged from the analysis, providing an understanding of the determinants for behavioural change, including meaningful social interactions, family dynamics and health trajectories. The mothers in the study valued the social aspects of their participation; however, they believed that gaining knowledge in combination with social interaction made their presence also meaningful. Further, the participants recognised the role of family dynamics primarily the interactions within the family, family structure and traditional practices as influencing oral health-related behaviour among children. Participants reported having experienced a change in general health owing to changed behaviour. They started to understand the association between general health and oral health that further motivated them to follow healthier behavioural routines.CONCLUSIONS: The results from this study show that oral health promotion through reflection and dialogue with the communities, together with other stakeholders, may have the potential to influence behavioural change and empower participants to be future ambassadors for change.
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6.
  • Rämgård, Margareta, et al. (författare)
  • Strategies for diversity: medical clowns in dementia care : an ethnographic study
  • 2016
  • Ingår i: BMC Geriatrics. - : BMC. - 1471-2318 .- 1471-2318. ; :16
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: As nursing homes become increasingly diverse, dementia care needs a wider range of culturally responsive strategies for individual and collective social interactions. While previous studies conclude that medical clowns have positive effects on verbal and non verbal social interactions, research is lacking from the perspective of residents’ cultural background. Aim: The aim of this study was to identify interaction strategies employed by medical clowns in culturally diverse dementia care settings Method: An ethnographic approach was used and data were collected through observation of interactions between medical clowns and residents with dementia in two nursing homes during a ten week period. Results: The observations showed that the medical clowns interacted with residents by being tuned in and attentive to the residents as individuals with a unique life-history, confirming each person´s sense of self. The clowns used sensory triggers, encouragement and confirmation in culturally responsive ways to bond socially with the residents in their personal spaces. The clowns involved objects in the daily environment that were meaningful for the residents, and paid attention to significant places and habits in the past. The clowns further contributed to joint interaction in the common spaces in the nursing homes, using music and drama Conclusion: The strategies employed by medical clowns in activities with older people with dementia appear to support social interaction. The medical clowns used the social and material environment in culturally responsive ways to strengthen individuals’ sense of self, while contributing to a sense of togetherness and interaction among residents in the common spaces. Findings suggest that both verbal and non-verbal cultural content affected social interaction. The non-demanding encouraging way the clowns tuned in to the residents as individuals could help nurses and staff members improve ways of communication in social activities inside the nursing home.
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7.
  • Carlson, Elisabeth, et al. (författare)
  • Registered nurses' perceptions of their professional work in nursing homes and home-based care : A focus group study
  • 2014
  • Ingår i: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 51:5, s. 761-767
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: In Sweden, as well as in most industrialized countries, an increasing older population is expected to create a growing demand for health care staff. Previous studies have pointed to lack of proficient medical and nursing staff specialized in geriatric care, which poses serious threats to the care of a vulnerable population. At the same time, there are studies describing elderly care as a low-status career choice, attracting neither nurses nor student nurses. Judging from previous research it was deemed important to explore how nurses in elderly care perceive their work, thus possibly provide vital knowledge that can guide nurse educators and unit managers as a means to promote a career in elderly care. Objective: The aim of the present study was to illuminate how nurses, working in nursing homes and home-based care, perceived their professional work. Method: This was a qualitative study using focus groups. 30 registered nurses in seven focus groups were interviewed. The participants worked in nursing homes and home-based care for the elderly in rural areas and in a larger city in southern Sweden. The interviews were analyzed in line with the tradition of naturalistic inquiry. Results: Our findings illustrate how nurses working in elderly care perceived their professional work as holistic and respectful nursing with the older person at its centre. Three categories emerged during analysis: (1) establishing long-term relationships, (2) nursing beyond technical skills, and (3) balancing independence and a sense of loneliness. Conclusions: We suggest that nurse educators and nurse managers promote continuity and long term relationships with patients, as well as independence and the opportunity to provide holistic care as key aspects of elderly care. These key aspects can be used to attract and retain nurses to a much needed area as well as be used as positive examples that can influence values and attitudes towards a career in elderly care.
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