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Engelbrektsson L, Ottesen H, Daivadanam M, Matta L, Alvesson HM. 'I've just heard that there are people who feel like they need to exercise': a photo-elicitation study of values and priorities influencing physical activity in a socioeconomically disadvantaged neighbourhood in Uppsala, Sweden. BMJ Open 2024; 14:e085356. [PMID: 39209789 PMCID: PMC11367300 DOI: 10.1136/bmjopen-2024-085356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 08/12/2024] [Indexed: 09/04/2024] Open
Abstract
OBJECTIVE People living in socioeconomically disadvantaged neighbourhoods in Sweden engage less in physical activity compared with the general population, contributing to an elevated risk of cardiometabolic diseases. To inform targeted and effective public health interventions, understanding residents' lived experiences is essential. This study sought to understand the values and priorities associated with physical activity by people living in a socioeconomically disadvantaged neighbourhood in Region Uppsala, Sweden, informing a public health intervention to prevent cardiometabolic diseases and promote healthy and active living. DESIGN The study employed a photo-elicitation methodology, combining participants' photographs with semistructured interviews. Data were analysed using reflexive thematic analysis. SETTING A socioeconomically disadvantaged neighbourhood in the city of Uppsala, Sweden, characterised by a large proportion of households with low income, a large percentage of individuals living on economic aid, high unemployment rates, low educational attainment and high levels of poor health. PARTICIPANTS A total of 15 participants (8 women and 7 men) were purposively sampled between February and August 2023 and recruited via fieldwork, social media and local stakeholders. RESULTS Participants described challenging conditions for physical activity, including conflicting values and priorities between themselves and the local authorities. Four main areas emerged as sources of tension; difficulties influencing decision-making processes affecting the neighbourhood, unmet needs of gender-separated physical activity spaces, discrepancy between the perceived pressure and individual motivation to be active, and their perception of health being solely an individualised responsibility, but their need of support. CONCLUSIONS This study underscores the importance of understanding and navigating the values and priorities influencing physical activity among residents in a socioeconomically disadvantaged neighbourhood, when designing public health interventions. Findings reveal that residents' needs for being physically active are not met by the authorities who are perceived to have different priorities, and that the lack of influence of citizen voices undermines trust in the local authorities.
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Affiliation(s)
| | - Hedda Ottesen
- Global Health and Migration Unit, Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Meena Daivadanam
- Global Health and Migration Unit, Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Laran Matta
- Global Health and Migration Unit, Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
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Sherman AD, Febres-Cordero S, Bonds Johnson K, Clark KD, Klepper M, Duroseau B, Lin Y, Zhang W, Coleman M, Prakash D, Daniel GA, Chand AT, Kalu U, Tarter R, Allgood S, Cohen S, Kelly U, Balthazar M. Intersectionality in nursing research: A scoping review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2023; 5:100155. [PMID: 37982092 PMCID: PMC10655863 DOI: 10.1016/j.ijnsa.2023.100155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/21/2023] [Accepted: 09/25/2023] [Indexed: 11/21/2023] Open
Abstract
Background An intersectional approach to health research provides an analytical foundation to explain the multidimensionality of health status, resource accessibility, privilege, oppression, and current and historical context. The use of intersectionality in health research has known limitations. Its use in health-related fields too often focuses on outcomes, such as health disparities, rather than processes, such as power structures and social determinants. Objective This scoping review serves to examine how intersectionality has been implemented by nurses in the peer-reviewed literature. We offer insight into how it may be incorporated to inform future nursing research and healthcare provision. Design & Methods Systematic searches of PubMed (n = 257), SCOPUS (n = 807), EMBASE (n = 396), CINAHL (n = 224), and Health Source: Nursing and Academics (n = 491), published since the seminal publication on intersectionality (1989 - 2023), identified 131 research articles that met inclusion and exclusion criteria. Data extraction and synthesis were used to describe the breadth and depth of the literature specific to the application of intersectionality in nursing research. Results The included studies used intersectionality to examine the intersections of numerous identities, such as race, gender, and immigration status. However, most studies were descriptive/observational in nature, underreported their methods, and conducted deficit-based research instead of strength-based inquiries. Of note, the vast majority of included articles were published within the last five years. Conclusions Future researchers using intersectionality as a framework can improve their approach by reporting clear definitions and operationalization of intersectionality. Observational science dominated the included studies; future research should focus on intervention development and evaluation using an intersectional lens. Lastly, caution should be placed on research that focuses solely on deficits among marginalized communities, which places scientists at risk of perpetuating stereotypes or enhancing already-existing stigmas.
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Affiliation(s)
- Athena D. F. Sherman
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Sarah Febres-Cordero
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Kalisha Bonds Johnson
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Kristen D. Clark
- Department of Nursing, University of New Hampshire, Durham, NH, USA
| | | | | | - Yufen Lin
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Wenhui Zhang
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Mercy Coleman
- Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park, PA, USA
| | - Diane Prakash
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Gaea A. Daniel
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Arzina Tabassum Chand
- Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park, PA, USA
| | - Ugo Kalu
- Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park, PA, USA
| | - Robin Tarter
- Oregon Health and Science University, Portland, OR, USA
| | | | - Sydney Cohen
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
| | - Ursula Kelly
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
- Atlanta VA Health Care System, Atlanta, Georgia, USA
| | - Monique Balthazar
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road Office: 310, Atlanta, GA 30322, USA
- Ross and Carol Nese College of Nursing, Pennsylvania State University, University Park, PA, USA
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Nyikavaranda P, Pantelic M, Jones CJ, Paudyal P, Tunks A, Llewellyn CD. Barriers and facilitators to seeking and accessing mental health support in primary care and the community among female migrants in Europe: a "feminisms" systematic review. Int J Equity Health 2023; 22:196. [PMID: 37752502 PMCID: PMC10523615 DOI: 10.1186/s12939-023-01990-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 08/14/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Recent years have seen record levels of migration to Europe. Female migrants are at heightened risk of developing mental health disorders, yet they face barriers to accessing mental health services in their host countries. This systematic review aims to summarise the barriers and facilitators to accessing mental health support for female migrants in Europe. METHODS The review follows PRISMA guidelines, and the protocol was pre-published on PROSPERO. Six electronic databases were searched: CINAHL, Global Health Database, Medline, PsycARTICLES, PsycINFO and Web of Science. Thematic analysis was undertaken on the identified studies. A feminist quality appraisal tool was applied. RESULTS Eight qualitative, six quantitative and five mixed methods studies were identified. Barriers included a lack of information, stigma, religious and cultural practices and beliefs, and a lack of consideration of gender-specific needs within the health system. Gender-sensitive services, supportive general practitioners and religious leaders facilitated access. CONCLUSIONS The design of mental health research, services, policies, and commissioning of support for migrants must consider female migrant needs. Mental health support services must be culturally aware and gender sensitive. REGISTRATION The review protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO, registration number CRD42021235571.
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Affiliation(s)
- Patrick Nyikavaranda
- Department of Primary Care & Public Health, Brighton & Sussex Medical School, University of Sussex, Watson Building, Room 104, Falmer, Brighton, East Sussex, BN1 9PH, UK.
| | - Marija Pantelic
- Department of Primary Care & Public Health, Brighton & Sussex Medical School, University of Sussex, Watson Building, Room 104, Falmer, Brighton, East Sussex, BN1 9PH, UK
| | - Christina J Jones
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7XH, Surrey, UK
| | - Priyamvada Paudyal
- Institute for Global Health and Wellbeing School of Medicine, Keele University, Keele, Staffordshire, ST5 5GB, UK
| | - Alice Tunks
- Department of Primary Care & Public Health, Brighton & Sussex Medical School, University of Sussex, Watson Building, Room 104, Falmer, Brighton, East Sussex, BN1 9PH, UK
| | - Carrie D Llewellyn
- Department of Primary Care & Public Health, Brighton & Sussex Medical School, University of Sussex, Watson Building, Room 104, Falmer, Brighton, East Sussex, BN1 9PH, UK
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Monserrate-Gómez S, Rubio-Rico L, Cuesta-Martínez R, Raventós-Torner RD, Roca-Biosca A, de Molina-Fernández I. 'Football and dancing are in our blood': culture promoting sports practice among immigrants in Europe. Health Promot Int 2023; 38:7026243. [PMID: 36738452 DOI: 10.1093/heapro/daac202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The current state of knowledge indicates that regular sports practice helps prevent and treat non-communicable diseases. The promotion of sport is, therefore, an important community health intervention for maintaining and improving the health of individuals and populations. Culture is identified as being associated with sports practice and sedentary behaviour of ethnic and national minorities. This study aims qualitatively to analyse the potential for culture as a basis for the promotion of sport among immigrants in four regions of Mediterranean Europe. Ten focus groups (n = 62) were conducted with immigrants-adults and young people over the age of 11-and people involved in promoting sport. Thematic content analysis was conducted. The results enabled identifying two major issues: sport as a vehicle for cultural expression and synergies between sport and culture. Accordingly, sport serves to express global, local and non-ethno-national cultural belonging. Regarding synergies, culture and sport feed each other positively and contribute to immigrants' health and cultural well-being. Culture as a strategy for promoting sports practice requires an interdisciplinary approach that involves collaboration between healthcare practitioners and social sciences professionals. There is also a need to use the various axes of cultural definition-global, local and non-ethno-national-of those involved, and for them to take part themselves in designing sports activities. Moreover, promoting sport through non-ethno-national axes of cultural definition may help with immigrants' social inclusion, as intercultural relations between migrants and newcomers are promoted.
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Affiliation(s)
- Sílvia Monserrate-Gómez
- UNESCO Chair for Intercultural Dialogue in the Mediterranean, Rovira i Virgili University, Tarragona, Spain
| | - Lourdes Rubio-Rico
- UNESCO Chair for Intercultural Dialogue in the Mediterranean, Rovira i Virgili University, Tarragona, Spain.,Nursing Department, Rovira i Virgili University, Tarragona, Spain
| | | | | | - Alba Roca-Biosca
- Nursing Department, Rovira i Virgili University, Tarragona, Spain
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Lindsjö C, Sjögren Forss K, Kumlien C, Rämgård M. Health promotion focusing on migrant women through a community based participatory research approach. BMC WOMENS HEALTH 2021; 21:365. [PMID: 34656089 PMCID: PMC8520311 DOI: 10.1186/s12905-021-01506-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 10/06/2021] [Indexed: 11/10/2022]
Abstract
Background Migrants are often more vulnerable to health issues compared to host populations, and particularly the women. Therefore, migrant women’s health is important in promoting health equity in society. Participation and empowerment are central concepts in health promotion and in community-based participatory research aimed at enhancing health. The aim of this study was to identify conditions for health promotion together with women migrants through a community-based participatory research approach. Methods A community-based participatory research approach was applied in the programme Collaborative Innovations for Health Promotion in a socially disadvantaged area in Malmö, Sweden, where this study was conducted.
Residents in the area were invited to participate in the research process on health promotion. Health promoters were recruited to the programme to encourage participation and a group of 21 migrant women participating in the programme were included in this study. A qualitative method was used for the data collection, namely, the story-dialogue method, where a process involving issue, reflections and actions guided the dialogues. The material was partly analysed together with the women, inspired by the second-level synthesis. Results Two main health issues, mental health and long-term pain, were reflected upon during the dialogues, and two main themes were elaborated in the process of analysis: Prioritising spare time to promote mental health and Collaboration to address healthcare dissatisfaction related to long-term pain. The women shared that they wanted to learn more about the healthcare system, and how to complain about it, and they also saw the togetherness as a strategy along the way. A decision was made to start a health circle in the community to continue collaboration on health promotion. Conclusions The community-based participatory research approach and the story dialogues constituted an essential foundation for the empowerment process. The health circle provides a forum for further work on conditions for health promotion, as a tool to support migrant women’s health.
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Affiliation(s)
- Cecilia Lindsjö
- Department of Care Science, Faculty of Health and Society, Malmö University, Jan Waldenströms Gata 25, 20506, Malmö, Sweden.
| | - Katarina Sjögren Forss
- Department of Care Science, Faculty of Health and Society, Malmö University, Jan Waldenströms Gata 25, 20506, Malmö, Sweden
| | - Christine Kumlien
- Department of Care Science, Faculty of Health and Society, Malmö University, Jan Waldenströms Gata 25, 20506, Malmö, Sweden
| | - Margareta Rämgård
- Department of Care Science, Faculty of Health and Society, Malmö University, Jan Waldenströms Gata 25, 20506, Malmö, Sweden
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Alnuqaidan H, Alhajraf A, Mathew P, Ahmad M. Transitional Shock of Multi-Nationality Newly Graduate Nurses in Kuwait. SAGE Open Nurs 2021; 7:2377960821998530. [PMID: 33869747 PMCID: PMC8020764 DOI: 10.1177/2377960821998530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 12/14/2020] [Accepted: 02/06/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction The transitional period of newly graduate nurses became more stressful, different coping mechanisms are essential. Therefore, effective coping with transition-related stress and anxiety is important for the life and professional of those nurses. Objectives To examine the transitional shock through assessing the occupational stress and coping mechanism of multi-nationality newly graduate nurses in Kuwait. Methods A descriptive correlational design was used to identify the occupational stress of the newly graduate nurses (NGNs) and their coping mechanisms during the transitional period to their professional life. All the NGNs were recruited. The total number of participants was 152 nurses. Results Highly significant correlations on almost all stress domains with p-values P < 0.01. We found that "Death and dying" was ranked as the highest stressor with a mean score of 6.20, followed by "uncertainty concerning treatment" with a mean score of 5.59, and in the "Inadequate preparation" was the least stressor with a mean score of 1.64. Conclusion "Religious coping" was the highest-ranked coping mechanism. In conclusion, NGNs have to adjust quickly to the new practical atmosphere encountered in the health care settings by using the proper coping mechanisms techniques.
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Affiliation(s)
| | - Ali Alhajraf
- College of Nursing, Public Authority of Applied Education and Training (PAAET), Safat, Kuwait
| | - Princy Mathew
- Nursing Department, Ministry of Health, Al Asimah, Kuwait
| | - Muayyad Ahmad
- Clinical Nursing Department, School of Nursing, The University of Jordan, Amman, Jordan
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El Masri A, Kolt GS, George ES. A systematic review of qualitative studies exploring the factors influencing the physical activity levels of Arab migrants. Int J Behav Nutr Phys Act 2021; 18:2. [PMID: 33407603 PMCID: PMC7788960 DOI: 10.1186/s12966-020-01056-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/09/2020] [Indexed: 12/22/2022] Open
Abstract
Background Evidence suggests that Arab migrant populations engage in low levels of physical activity. To our knowledge, there are no reviews that explore the perspectives of Arab migrant populations on the factors influencing physical activity. The aim of this systematic review was to thematically synthesise qualitative literature on the factors influencing physical activity among Arab migrant populations. Methods Five electronic databases (CINAHL, SPORTDiscus, PsychoInfo, MEDLINE, Embase) were searched in July 2018 and searched again in April 2020. A manual search in Google Scholar was also performed using keywords and the reference lists of included studies were also screened to identify further articles. The eligibility criteria for inclusion were studies that sampled adult (≥18 years) Arab migrant populations, used qualitative methodology, explored the factors influencing physical activity as a primary aim, and were published in English. The 10-item Critical Appraisal Skills Programme (CASP) checklist was used to assess methodological quality of individual studies. The results of the studies were thematically synthesised using the qualitative software Quirkos v1.6. Results A total of 15 studies were included, with the largest proportion of studies conducted in Australia, followed by the United States, Netherlands, Sweden, and then Canada. Five studies exclusively sampled Arab migrant populations in their study. A total of 7 major themes influencing physical activity among Arab migrants emerged from the synthesis: culture and religion, competing commitments and time, social factors, health-related influences, accessibility issues, outdoor environment, and the migratory experience. Conclusions The findings of this review highlighted the various factors influencing the physical activity levels of Arab migrant adults. While many of the factors influencing physical activity are shared with those experienced by other populations (e.g., time constraints), for Arab migrant populations there are other more unique factors closely associated with culture and religion that appear to influence their levels of physical activity. The findings of this review could be used to inform the design of physical activity interventions targeting Arab migrant populations. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-020-01056-w.
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Affiliation(s)
- Aymen El Masri
- School of Health Sciences, Western Sydney University, Penrith, NSW, 2751, Australia
| | - Gregory S Kolt
- School of Health Sciences, Western Sydney University, Penrith, NSW, 2751, Australia
| | - Emma S George
- School of Health Sciences, Western Sydney University, Penrith, NSW, 2751, Australia. .,Translational Health Research Institute, Western Sydney University, Penrith, Australia.
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