| 1. |
- Häggström Westberg, Katrin, 1968-
(författare)
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Exploring mental health and potential health assets in young people
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Young people in Sweden generally claim to have a good quality of life, but also report increasing mental health problems. It is a concern that only a minority of young people seek and/or access support when encountering mental health problems as mental health is a fundamental human right and integral to a positive development in both childhood and throughout the lifespan. There are uncertainties as to how to facilitate help-seeking and promote mental health among young people and previous studies have often focused on risk-reduction. A shift from a pathological view to a resource-based perspective of mental health can be achieved by adopting a health assets’ approach. This approach also ascribes due emphasis to the fact that mental health is developed within a social context, where both individual and structural health assets, such as the support system, are of importance. With this in mind, the overall aim of this thesis was to explore individual and structural health assets in relation to the mental health of young people.This thesis is based on four studies using both quantitative (Studies I and II) and qualitative (Study III) methods as well as a scoping review method with a qualitative synthesis (Study IV). Studies I and II had a cross-sectional design and utilized data from self-reported health-related ratings collected in schools in 2011. The association between socio-economic determinants and self-rated mental health in two age groups (11-13 and 14-16) was explored in Study I, and optimism and pessimism as a bi-dimensional construct, and its impact on health-related quality of life and potential to function as a health asset was explored in Study II. In Studies III and IV, the help- seeking process was explored from the perspective of young people, firstly with constructivist grounded theory in Study III based on interviews of young people seeking help for mental health problems within a local setting, and secondly, through a scoping review examination and qualitative synthesis of national and international literature on help-seeking in Study IV.The results identified potential health assets on both individual and structural levels. The explored health assets on an individual level were socio-economic status and socio-demographic factors (Study I), dispositional optimism (Study II) and individual resources for help-seeking (Studies III and IV), while health assets on a structural level were explored through the experience of and perceptions of young people’s help-seeking process(Studies III and IV). The individual health assets of socio-economic status and migratory background were seen to affect mental health differently for boys and girls with the boys being susceptible to an accumulation of socio-economic risk factors including family wealth affecting their mental health negatively, and the mental health of the young girls with a migratory background being affected positively (Study I).The individual health asset of optimism was found to be potentially supportive for help-seeking and mental health (Study II). Young people were optimistic about their future but there was a significant decrease in optimism and health-related quality of life, and a significant increase in pessimism, with age. Optimism was independently and positively associated with a high level of health-related quality of life among young people, even when adjusting for parents’ marital status, family country background and gender. Knowledge and a desire for self-reliance were identified as potential individual health assets mainly in regard to the help-seeking process (Studies III and IV). Young people expressed how their knowledge of mental health and the support system was inadequate, rendering a feeling of insecurity, however, they also expressed a strong desire for self-reliance in regard to their mental health. Help-seeking was characterised as a dynamic and psychosocial process without sequentially fixed stages. Potential health assets on a structural level were identified as support through social networks, and a responsive, collective and accessible support system. However, young people perceived the support system as unresponsive, focused on protocol instead of person, fragmented and spread, and lacking in accessibility. The results implied that equipping young people with sufficient knowledge would capitalize on the individual health assets of self-reliance and optimism, conducive to help-seeking and mental health, but that the support system needs to improve in order to meet the particular needs of young people.
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| 2. |
- Kostenius, Catrine, 1962-, et al.
(författare)
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From Hell to Heaven? Lived experiences of LGBTQ migrants in relation to health and their reflections on the future
- 2022
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Ingår i: Culture, Health and Sexuality. - Abingdon : Taylor & Francis. - 1369-1058 .- 1464-5351. ; 24:11, s. 1590-1602
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Tidskriftsartikel (refereegranskat)abstract
- This paper explores the lived experiences of LGBTQ migrants participating in a civil society group in Sweden during the migration process and their reflections on the future. Eleven migrants who self-identified as LGBTQ (seven male/gay, one female/lesbian, one female/bi-sexual, and two transgender/gay persons) from three local support groups for LGBTQ migrants agreed to be interviewed. Participants came from Guinea, Iraq, Kurdistan, North Macedonia, Nigeria, Nicaragua, Pakistan, the Russian Federation, Syria, Uganda and Ukraine. Interpretative-phenomenological analysis resulted in three themes: Past: from daily stress to the fear of being killed; Present: safety, belonging and resources to support the transition to a new life; and Future: making a positive difference or being afraid of what’s ahead. Participants’ health-related journeys and reflections about the future were complex in terms of favourable and unfavourable lived experiences, which become resources and risks for personal development. Study findings offers an enhanced awareness of the complex landscape of, and interaction between, vulnerability and potentiality. Based on the findings, we suggest the adoption of a health promoting approach focusing on the LGBTQ migrants’ strengths and personal resources.
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| 3. |
- Pelters, Pelle, Ph.D. 1972-, et al.
(författare)
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“This Group is Like a Home to Me:” understandings of health of LGBTQ refugees in a Swedish health-related integration intervention: a qualitative study
- 2022
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Ingår i: BMC Public Health. - London : Springer Nature. - 1471-2458. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: When large numbers of asylum seekers immigrate to a country, civil society is encouraged to contribute to their integration. A subgroup of asylum seekers comprising lesbian, gay, bisexual, transgender, or queer (LGBTQ) refugees are specifically deemed vulnerable to developing health and integration problems due to the double stigma of being a sexual/gender minority and a refugee. The Swedish Federation for LGBTQ Rights (RFSL) is a civil societal organization that has established the support group “RFSL Newcomers,” a health-related integration intervention that targets such refugees. The aim of the present study is reconstructing the subjective understanding of health of LGBTQ refugees.Methods: Eleven participants in Newcomers and eight organizers were interviewed about LGBTQ refugees’ experiences of migrating and participating in RFSL Newcomers. Qualitative content analysis was used to reconstruct subjective understandings of health that were constructed in these narratives. As the data did not originally concentrate on exploring understandings of health, a broad theoretical approach was used as a heuristic for the analysis, which focused on the common everyday approach of conceptualizing health as wellbeing.Results: The narratives revealed three interconnected, interdependent categories of understanding health in which tensions occur between wellbeing and ill-being: belonging versus alienation, security and safety versus insecurity, and recognition versus denial. The categories contribute to an overarching theme of health as framed freedom – i.e., freedom framed by conditions of society.Conclusions: For our participants, belonging, recognition, and security/safety are conceptual elements of understanding health, not its social determinants. Thus, these understandings emphasize relational and existential meanings of health (theoretical implication). As for practical implications, the understandings of health were connected to being either inside or outside the Newcomers group and a new society, depending on whether LGBTQ refugees comply with social requirements. As a significant actor that is representative of the cultural majority and a facilitator of LGBTQ refugees’ resettlement process, RFSL provides LGBTQ refugees with crucial orientations for becoming a “good migrant” and a “good LGBTQ person,” yet a “bad bio-citizen.” Generally, organizers of interventions may enhance the effectiveness of their interventions when relational, existential, and biomedical understandings of health are all incorporated.
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| 4. |
- Bittlingmayer, Uwe H., et al.
(författare)
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Health Promotion of Refugees – Empirical Evidence from Approaches in two European Countries
- 2019
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Ingår i: 9th Nordic Health Promotion Research Conference. ; , s. 39-40
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Konferensbidrag (refereegranskat)abstract
- The migration of many people to European countries in the last years created various challenges and evoked diverse responses. But rarely, lessons learned and good practice for health promotion interventions are exchanged between countries nor common solutions sought. In this workshop, we will shed light on the health situations of refugees in Sweden and Germany, and present four research projects regarding the health of refugees.Initially, we will outline the situation for refugees in the two countries generally, provide ample evidence on the health needs and particular burden of refugees, and discuss the increasing influence of racism. Finally, we will discuss the issue health promotion of refugees, needs, approaches, limitations.
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| 5. |
- Booth, Frederick, et al.
(författare)
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A Mental Health and Well-Being Chatbot : User Event Log Analysis
- 2023
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Ingår i: JMIR mhealth and uhealth. - : JMIR Publications. - 2291-5222. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Background: Conversational user interfaces, or chatbots, are becoming more popular in the realm of digital health and well-being. While many studies focus on measuring the cause or effect of a digital intervention on people’s health and well-being (outcomes), there is a need to understand how users really engage and use a digital intervention in the real world.Objective: In this study, we examine the user logs of a mental well-being chatbot called ChatPal, which is based on the concept of positive psychology. The aim of this research is to analyze the log data from the chatbot to provide insight into usage patterns, the different types of users using clustering, and associations between the usage of the app’s features.Methods: Log data from ChatPal was analyzed to explore usage. A number of user characteristics including user tenure, unique days, mood logs recorded, conversations accessed, and total number of interactions were used with k-means clustering to identify user archetypes. Association rule mining was used to explore links between conversations.Results: ChatPal log data revealed 579 individuals older than 18 years used the app with most users being female (n=387, 67%). User interactions peaked around breakfast, lunchtime, and early evening. Clustering revealed 3 groups including “abandoning users” (n=473), “sporadic users” (n=93), and “frequent transient users” (n=13). Each cluster had distinct usage characteristics, and the features were significantly different (P<.001) across each group. While all conversations within the chatbot were accessed at least once by users, the “treat yourself like a friend” conversation was the most popular, which was accessed by 29% (n=168) of users. However, only 11.7% (n=68) of users repeated this exercise more than once. Analysis of transitions between conversations revealed strong links between “treat yourself like a friend,” “soothing touch,” and “thoughts diary” among others. Association rule mining confirmed these 3 conversations as having the strongest linkages and suggested other associations between the co-use of chatbot features.Conclusions: This study has provided insight into the types of people using the ChatPal chatbot, patterns of use, and associations between the usage of the app’s features, which can be used to further develop the app by considering the features most accessed by users.
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| 6. |
- Boyd, Kyle, et al.
(författare)
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Usability testing and trust analysis of a mental health and wellbeing chatbot
- 2022
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Ingår i: Proceedings of the 33rd European Conference on Cognitive Ergonomics (ECCE 2022). - New York, NY, USA : Association for Computing Machinery.
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Konferensbidrag (refereegranskat)abstract
- Mental health chatbots are particularly useful for those who are isolated and may have difficulty attending services or for those who are reluctant to speak to a professional. In this study, the usability and trust of a chatbot known as ’ChatPal’ has been assessed. ChatPal has been developed by an interdisciplinary team encompassing health service providers, local authorities, charities and universities to promote positive mental wellbeing among individuals in rural areas across Europe. This study employed a usability test protocol to recruit representative users to complete a set of tasks using the ChatPal chatbot. Usability issues were assessed along with trust and users’ satisfaction on the System Usability Scale and the Chatbot Usability Questionnaire. The study shows the usability issues and trust with a mental health chatbot and highlights recommendations for improvement.
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| 7. |
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| 8. |
- Kostenius, Catrine, 1962-, et al.
(författare)
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Health Dialogue Experiences of Students, Teachers and School Nurses in Swedish Health-promoting Schools
- 2021
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Ingår i: Californian Journal of Health Promotion. - : California State University. - 1545-8725. ; 19:1, s. 22-33
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Tidskriftsartikel (refereegranskat)abstract
- According to Swedish law, all students are to be offered health dialogues with a school nurse, which helps to promote students’ health literacy. However, research shows that the health dialogues are not being used to their fullest potential. To explore how health dialogues are experienced by school actors – students, teachers and school nurses. The 93 participants from 14 municipalities in northern Sweden wrote open letters sharing their experiences with health dialogues. Phenomenological analysis resulted in two themes with three sub-themes each that describe well-functioning health-promoting schools in which health promotion was seen as a shared practice among staff. In contrast, the participants expressed frustration or resignation with the challenges connected to health dialogues. When given a voice, school actors paint an informative collective picture of health dialogues. Based on our findings, we argue that health dialogues can \promote students' health literacy and enable collaboration between different actors within educational systems. Furthermore, promoting health in school must be viewed as a common assignment for all school staff, and support from school leadership is needed to systematically use the results from health dialogues to inform effective health promotion practice.
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| 9. |
- Kostenius, Catrine, 1962-, et al.
(författare)
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Open letters about health dialogues reveal school staff and students’ expectations of school health promotion leadership
- 2022
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Ingår i: Health Education. - : Emerald Group Publishing Limited. - 0965-4283 .- 1758-714X. ; 122:3, s. 318-334
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: This study explores to what extent health promotion policy in practice and leadership engagement is reflected in school actors’ experiences of health dialogues (HDs) and their ideas about promoting health and learning in schools. Design/methodology/approach: The 93 participants consisted of 44 school nurses, 37 students in grades 4, 7 or the first year of high school and 12 teachers, who shared their experiences with HDs by writing open letters. Findings: The qualitative content analysis resulted in four themes: Putting health on the agenda, Finding a common goal, Walking side by side and Pointing out a healthy direction. The participants’ expectations of school health promotion leadership are revealed in suggestions on how the HDs can fulfill both the educational assignment and promote student health. Practical implications: Based on the findings, we argue that for successful school health promotion leaders need to acknowledge the field of tension where leadership has to take place, anchor health promotion policy and administer “a Sandwich approach†– a top-down and bottom-up leadership simultaneously that facilitates school-based health promotion. Originality/value: When different school actors (school nurses, teachers and students) are given a voice, a collective picture of HDs can emerge and help develop health promotion practices.
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| 10. |
- Kostenius, Catrine, 1962-
(författare)
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School Nurses’ Experiences With Health Dialogues : A Swedish Case
- 2023
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Ingår i: Journal of School Nursing. - : Sage Publications. - 1059-8405 .- 1546-8364. ; 39:5, s. 345-356
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe school nurses’ experiences with health dialogues and elicit their thoughts about how schools can reach the full potential in promoting students’ health literacy and learning. The phenomenological analysis resulted in four themes: (i) A golden opportunity…or not, (ii) Like a double-edged sword, (iii) Able or unable organizations, and (iv) Visions of good conditions for health and learning. School nurses’ experiences revealed that health dialogues are beneficial and can be valuable tools in promoting health and learning when (1) the health dialogues are an important part of the educational assignment, (2) school nurses are valued for fulfilling the educational assignment, and their work conditions are reasonable, (3) the results from the health dialogues and health questionnaires are used systematically to promote health and learning, (4) a “whole-school approach” is used to build enabling relationships among all school staff and students.
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