| 1. |
- Farah Mohamed, Amal, et al.
(författare)
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“Using Contraceptives Is Abandoning Our Culture” : A Qualitative Study of Contraceptive Use Among Somali Women in Finland
- 2022
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier. - 1877-5756 .- 1877-5764. ; 32
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Several studies have reported that Somalis have negative attitudes about using modern contraceptives. However, little attention has been paid to the differences in Somali women's attitudes toward contraceptives across generations and the attitude change happening overtime in Somali women's attitudes toward contraception. This study explores attitudes toward contraceptives and factors influencing contraceptive use, among first- and second-generation Somali women living in Finland.Methods: The study follows a qualitative design with data collection using in-depth interviews. Sixteen women were interviewed regarding their knowledge of, attitude toward, and use of contraceptives. Eight of the study participants were first-generation and eight were second-generation Somali women living in Finland. The data were analyzed using a thematic approach guided by a cultural anthropology framework.Results: Three main themes emerged in the data analysis: (1) Culture influencing Somali women's attitudes toward contraceptives; (2) information sources can work differently within the same cultural group; and (3) Somali women's perspectives on contraceptives change over time. Cultural, religion, taboo, and knowledge resources are used to understand the whole concept of Somali women's attitude toward and use of contraceptives. Hence, the study shows the diverse opinions of Somali women. According to the informants the main underlying factors influencing Somali women's attitudes toward contraceptives were education, culture, misinterpreted religion, and social pressure.Conclusions: According to the Finish resident women interviewed for this study, Somali culture do not support the use of modern contraceptives. Even though attitudes towards contraceptives are slowly changing, there is a need for SRH education, particularly among first-generation Somalis. Second-generation women are generally more open to the use of modern contraceptives. The study also draws attention to the need to improve the training of health care professionals regarding the handling of culturally sensitive topics such as contraception use.
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| 2. |
- Goicolea, Isabel, et al.
(författare)
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Protecting, managing and bending boundaries: a biomedicalization perspective on Swedish youth clinics’ responses to mental (ill) health
- 2022
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Ingår i: BMC Health Services Research. - : BioMed Central. - 1472-6963. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Sweden has provided around 300 youth clinics (YCs) to address the health needs of young people since the 1970s. During the last few years, and as part of an effort to strengthen mental healthcare for young people, YCs’ role in the provision of mental healthcare has been widely debated. With such debates as background, the aim of this study is to analyse Swedish YCs’ responses to the mental (ill) healthcare needs of young people, from the perspective of national level stakeholders.Methods: We used thematic analysis of interviews with eight national level stakeholders in the field of youth mental health in Sweden. Building upon the concept of biomedicalization we examined the discourses on mental (ill) health, healthcare and youth that such responses reproduce.Results: YCs engage in the three simultaneous, but at times contradictory, responses of protecting, managing and bending boundaries. Remaining true to their mission as a health-promotion service compels them to protect their boundaries and limit the type of mental health issues they address. However, the perceived malfunctioning of specialized services has led them to bend these boundaries to allow in more young people with severe mental health problems. Caught between protecting and bending boundaries, the response of managing boundaries to decide who should be allowed in and who should be sent elsewhere has emerged as a middle-way response. However, it is not free from conflicts.Conclusion: Building upon the concept of biomedicalization, this study poses two questions. The first relates to whether it is possible to support young people and their health without reinforcing discourses that represent young people as collectively at risk, and if so how this can be done. The second relates to the provision of mental healthcare for young people, and the need to identify conditions for integrating diagnosis and treatment within YCs, without hindering their holistic and youth-centred approach.
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| 3. |
- Goicolea, Isabel, et al.
(författare)
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Widening the scope of mental health with a 'youth centred' approach : a qualitative study involving health care professionals in Sweden’s youth clinics
- 2024
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to explore how health care providers at youth clinics (YCs) in Sweden engage with, focus on, and navigate across the mental health youth space, while upholding the core bedrock principle of "youth-centeredness".Methods: Qualitative interviews were conducted with 21 health care professionals working in three YCs located in three different regions of Sweden. Data were analysed using reflexive thematic analysis informed by the work of Braun and Clarke.Results: The three themes were: 1) "youth mission-at the core of the YCs" work and challenged by a stronger involvement in mental ill health'; 2) "YCs" unique and complementary role in the youth mental health system: a holistic perspective, team work, and a focus on normalization', and 3) "Caught between a rock and a hard place: to treat at a care level that is not optimal for the young users" needs or to refer within an unreliable system'.Conclusion: This study reflects the individuality and key features of YCs, their widening roles within the mental health sphere, and the challenges faced in maintaining and expanding the characteristic "youth-centred" approach while expanding their work with mental health
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| 4. |
- Hellberg, Lena, et al.
(författare)
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Ett nationellt sammanhållet system för kunskapsbaserad vård : ett system, många möjligheter
- 2020
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Utredningens förslag har primärt två syften. Förslagen syftar dels till att öka förutsättningarna för staten att göra de insatser som mest effektivt bidrar till att målen med hälso- och sjukvården nås, dels till att öka förutsättningarna för hälso- och sjukvårdens professioner att arbeta kunskapsbaserat.Hälso- och sjukvården är en komplex verksamhet med många olika aktörer. För att få ihop hälso- och sjukvården till en fungerande helhet behövs strukturer och väl fungerande samarbeten.Utredningens uppdrag handlar i grunden om att utveckla och stärka strukturer, förutsättningar och samarbeten för att nå en god vård. Utredningens samlade förslag, bedömningar och rekommendationer bidrar till bättre förutsättningar för en långsiktig utveckling där staten, regionerna och kommunerna kan arbeta tillsammans mot målen med hälso- och sjukvården och därmed skapa värde för patienten. Detta görs genom att:• underlätta för regeringen att styra mer strategiskt, kunskapsbaserat och långsiktigt hållbart. En förbättrad uppföljning av statliga initiativ och ett mer strukturerat samarbete mellan myndigheterna bidrar till att skapa ett utvecklat underlag för regeringens beslut om nya insatser.• förutsättningar för att arbeta kunskapsbaserat lokalt i regioner och kommuner stärks bl.a. genom att staten fortsätter att utveckla sitt stöd. Mer fokus än i dag läggs på stöd till den kommunala hälso- och sjukvården.• ett nationellt sammanhållet system för kunskapsbaserad vård får långsiktiga förutsättningar att utvecklas genom att en överenskommelse sluts mellan stat, regioner och kommuner. Principer och strukturer för ett långsiktigt samarbete läggs fast där några centrala utgångspunkter är en gemensam målbild samt principer för prioriterings- och arbetsprocesser.
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| 5. |
- Hultcrantz, Monica, et al.
(författare)
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From evidence to policy on a national level : supporting the government’s role in a learning healthcare system
- 2020
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Ingår i: Cochrane Database of Systematic Reviews. - 1469-493X. ; 9, s. 190-190
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Tidskriftsartikel (refereegranskat)abstract
- Background: In August 2018, the Swedish government appointed a special investigator to support a national ecosystem for evidence-based healthcare. In November 2019, the inquiry received an additional task now focusing on follow-up to enable a more strategic, evidence-based and long-term sustainable management of health care on a national level. Since healthcare systems around the world face similar challenges, we believe the results of the investigation are highly relevant for a broader audience.Objectives: To analyze how governmental agencies can better support a comprehensive follow-up of health care and thereby create a learning system on a national level. This includes following the effects of the government’s initiatives and reforms and analyzing where future governmental interventions are needed.Methods: The investigator and her team have worked with an expert committee including representatives of governmental agencies, healthcare professions and healthcare providers, as well as a reference group of patient representatives. Additional information has been collected through questionnaires, workshops and meetings with stakeholders and other governmental inquiries working on related topics. Background information was collected from published research, governmental reports, existing regulations etc.Results: Although roughly estimated more than 1000 full-time government employees work with followup in Sweden, the quality, effectiveness and equity in health care is not improving at the anticipated rate. Our findings suggest that a co-ordination of the different initiatives is a prerequisite for creating a learning system on a national level. Key challenges arise in the interface between evidence and policy. At the Colloquium, we will present possible solutions to these challenges using the Swedish healthcare system as an example.Conclusions: Although a lot of efforts are made in conducting and developing methods for evidence generation, implementation and follow-up, it is apparent that the full value for patients is not reached. Facilitators are needed for a learning system on a national level, where the government’s initiatives efficiently contribute to an increased quality, effectiveness and equity in health care. Sharing experiences from national efforts can be one way of increasing the understanding of what these facilitators are. Patient or healthcare consumer involvement: We have received valuable input through regular meetings with a reference group of six representatives from different patient organizations throughout the work. The expert committee linked to the investigation also included a patient representative adding important perspectives to the discussions.
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| 6. |
- Johansson, Katarina, et al.
(författare)
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Celiac disease and upper secondary school achievement in Sweden : A retrospective cohort study
- 2022
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Ingår i: BMC Pediatrics. - : BioMed Central (BMC). - 1471-2431. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Both undiagnosed celiac disease and some chronic childhood diseases are associated with lower academic achievement. However, there is little knowledge of achievements in those diagnosed with celiac disease. Our aim was to investigate school achievements in upper secondary school among Swedish adolescents with celiac disease.METHODS: We performed a retrospective cohort study using register data. We analyzed choice of upper secondary school program, completion of upper secondary school including achievements of basic eligibility for college/university, and final grade in individuals with celiac disease diagnosed before 15 years of age, born 1991-97. We compared with the Swedish population of the same birth years. Analyses were adjusted for sex, year of birth, living region at 17 years of age, and parental education as well as income.RESULTS: The cohort included 734 074 individuals, whereof 3 257 (62% females) with celiac disease. There was no significant difference in choice of upper secondary school program. No significant difference was found in completion or achieving basic eligibility for college/university in adjusted analyses. The mean final grade in the celiac disease group was 13.34 (standard deviation 4.85) compared to 12.78 (standard deviation 5.01) in the reference population (p < 0.001), out of a maximum of 20. The effect of celiac disease on final grade remained in adjusted analyses (p = 0.012).CONCLUSIONS: We found that diagnosed celiac disease does not negatively affect school achievements in upper secondary school. This finding suggests the diagnosis, treatment and follow-up programs of celiac disease could reverse potential deleterious academic processes.
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| 7. |
- Lindgren, Helena, et al.
(författare)
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The STAR-C Intelligent Coach : a Cross- Disciplinary Design Process of a Behaviour Change Intervention in Primary Care
- 2020
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Ingår i: pHealth 2020. - : IOS Press. - 9781643681122 ; , s. 203-208
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Konferensbidrag (refereegranskat)abstract
- A broad range of aspects are needed to be taken into consideration in the design and development of personalized coaching systems based on artificial intelligence methodologies. This research presents the initial phase of joining different professional and stakeholder perspectives on behavior change technologies into a flexible design proposal for a digital coaching system. The diversity and sometimes opposed views on content, behavior, purposes and context were managed using a structured argument-based design approach, which also feed into the behavior of the personalized system. Results include a set of personalization strategies that will be further elaborated with the target user group to manage sensitive issues such as ethics, social norms, privacy, motivation, autonomy and social relatedness.
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| 8. |
- Meili, Kaspar Walter, et al.
(författare)
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An initiative to develop capability-adjusted life years in Sweden (CALY-SWE) : Selecting capabilities with a Delphi panel and developing the questionnaire
- 2022
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 17:2
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Capability-adjusted life years Sweden (CALY-SWE) are a new Swedish questionnaire-based measure for quality of life based on the capability approach. CALY-SWE are targeted towards use in cost-effectiveness evaluations of social welfare consequences. Here, we first motivate the measure both from a theoretical and from a Swedish policy-making perspective. Then, we outline the core principles of the measure, namely the relation to the capability approach, embedded equity considerations inspired by the fair-innings approach, and the bases for which capabilities should be considered. The aims were to 1) the most vital capabilities for individuals in Sweden, 2) to define a sufficient level of each identified capability to lead a flourishing life, and to 3) develop a complete questionnaire for the measurement of the identified capabilities.Material and methods: For the selection of capabilities, we used a Delphi process with Swedish civil society representants. To inform the questionnaire development, we conducted a web survey in three versions, with each Swedish 500 participants, to assess the distribution of capabilities that resulted from the Delphi process in the Swedish population. Each version was formulated with different strictness so that less strict wordings of a capability level would apply to a larger share of participants. All versions also included questions on inequality aversion regarding financial, educational, and health capabilities.Results: The Delphi process resulted in the following six capabilities: Financial situation & housing, health, social relations, occupations, security, and political & civil rights. We formulated the final phrasing for the questionnaire based on normative reasons and the distribution of capabilities in the population while taking into account inequality aversion.Conclusion: We developed a capability-based model for cost effectiveness economic evaluations of broader social consequences, specific to the Swedish context.
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| 9. |
- Ng, Nawi, 1974, et al.
(författare)
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Sustainable Behavior Change for Health Supported by Person-Tailored, Adaptive, Risk-Aware Digital Coaching in a Social Context: Study Protocol for the STAR-C Research Programme
- 2021
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Ingår i: Frontiers in Public Health. - : Frontiers Media SA. - 2296-2565. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The Vasterbotten Intervention Programme (VIP) in the Region Vasterbotten Sweden is one of the very few cardiovascular disease (CVD) prevention programmes globally that is integrated into routine primary health care. The VIP has been shown as a cost-effective intervention to significantly reduce CVD mortality. However, little is known about the effectiveness of a digital solution to tailor risk communication strategies for supporting behavioral change. STAR-C aims to develop and evaluate a technical platform for personalized digital coaching that will support behavioral change aimed at preventing CVD. Methods: STAR-C employs a mixed-methods design in seven multidisciplinary projects, which runs in two phases during 2019-2024: (i) a formative intervention design and development phase, and (ii) an intervention implementation and evaluation phase. In the 1st phase, STAR-C will model the trajectories of health behaviors and their impact on CVDs (Project 1), evaluate the role of the social environment and social networks on behavioral change (Project 2) and assess whether and how social media facilitates the spread of health information beyond targeted individuals and stimulates public engagement in health promotion (Project 3). The findings will be utilized in carrying out the iterative, user-centered design, and development of a person-tailored digital coaching platform (Project 4). In the 2nd phase, STAR-C will evaluate the implementation of the coaching programme and its effectiveness for promoting behavioral change and the spreading of health information across social networks and via social media (Project 5). The cost-effectiveness (Project 6) and ethical issues (Project 7) related to the coaching programme intervention will be evaluated. Discussion: The STAR-C research programme will address the knowledge and practice research gaps in the use of information technologies in health promotion and non-communicable disease (NCD) prevention programmes in order to narrow the health inequality gaps. Ethics: STAR-C has received approval from the Swedish Ethical Review Authority (Dnr. 2019-02924;2020-02985). Dissemination: The collaboration between Umea University and Region Vasterbotten will ensure the feasibility of STAR-C in the service delivery context. Results will be communicated with decision-makers at different levels of society, stakeholders from other regions and healthcare professional organizations, and through NGOs, local and social media platforms.
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| 10. |
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