Promoting an equal and healthy environment: Swedish students' views of daily life at school

Young peoples' reflections about using a chatbot to promote their mental wellbeing in northern periphery areas - a qualitative study

An international research collaboration with researchers from northern Sweden, Finland, Ireland, Northern Ireland, Scotland and developed the ChatPal chatbot to explore the possibility of a multilingual chatbot to promote mental wellbeing in people of all ages. In Sweden the end users were young people. The aim of the current study was to explore and discuss Swedish young peoples' experiences of using a chatbot designed to promote their mental wellbeing. Young people aged 15-19 filled out an open-ended survey giving feedback on the ChatPal chatbot and their suggestions on improvements. A total of 122 survey responses were analysed. The qualitative content analysis of the survey responses resulted in three themes each containing two to three sub-themes. Theme 1, feeling as if someone is there when needed, which highlighted positive aspects regarding availability and accessibility. Theme 2, human-robot interaction has its limitations, which included aspects such as unnatural and impersonal conversations and limited content availability. Theme 3, usability can be improved, given technical errors due to lack of internet connection and difficulty navigating the chatbot were brought up as issues. The findings are discussed, and potential implications are offered for those designing and developing digital mental health technologies for young people.

"It's Kind of Our Everyday Life. It Sort of Becomes Natural": Everyday Violence and Violent Practices Among Young People

Although violence among youth remains an important, global issue, little research has been conducted regarding how young people themselves define violence and what practices in relation to violence that are evident in their everyday lives. Using an intersectional gender perspective, specifically exploring the intersection of gender, age, and class, this paper therefore aims to explore how young people define violence, as well as to explore what practices in relation to violence that are evident in young people's everyday lives. By using a photovoice methodology, 11 focus groups of young boys and girls (17-19 years old) living in two municipalities in northern Sweden were interviewed and asked to take photographs representing themes that were discussed. Overall, three main themes in the young peoples' stories were identified: Violence as ubiquitous, Easy prey and dangerous predators, and The way forward. The findings demonstrated that violence is pervasive, all-encompassing and normalized in young people's everyday lives, and that this violence is moderated by intersecting power orders of gender, age, and class. Any future theoretical frameworks or prevention strategies should therefore aim to include an intersectional perspective as well as including the voices of the youths themselves.

Effects of Green Plants on the Indoor Environment and Wellbeing in Classrooms—A Case Study in a Swedish School

Many schools in Sweden lack a proper indoor environment due to, e.g., poor thermal-envelope properties, overcrowded classes, poor visual appearance and insufficient ventilation. This study aims to explore the integration of a large number of indoor green plants into classrooms’ environments. This case study consists of three parts: measurements of the indoor environment including a final energy model, a questionnaire to the pupils with questions about their well-being and qualitative interviews with teachers. The case was two classrooms in a secondary education facility in central Sweden with an average annual temperature of 3 °C and a long and dark winter period with snow. The results showed 10% lower CO2 and slightly higher and more stable temperatures due to the green plants. Worries about climate change and war among the pupils decreased after several months with the plants and worry about infectious disease increased. The teachers experienced fresher air from the plants and used the plant stands for a flexible classroom design. The conclusion is that indoor plants have the potential to contribute to a better indoor environment, but due to the high number of uncontrolled variables (including the effect of COVID-19) in measurements of real-life conditions, more studies are needed.

The School as an Arena for Co-Creating Participation, Equity, and Well-Being-A Photovoice Study from Norway

Schools may play an essential role as an arena for co-creating community activities that enhance well-being, equity, and citizenship. Still, there is limited knowledge about physical and non-physical factors that contribute to well-being within such approaches. The aim of this study was to identify important factors for well-being as perceived by pupils, school employees, and parents in a community school in Norway. The participatory method photovoice was used, and seven pupils, six employees, and four parents participated by taking photos used as the basis for six focus group discussions. Transcripts of the discussions were analyzed using Systematic Text Condensation. The analysis showed that the participants experienced that the school’s built and natural environment, the activities happening there, and the human resources and organization at the school facilitated perceptions of safety, inclusion, and cohesion, which in turn contributed to well-being. Furthermore, the results showed that co-creating schools as a community arena could be an innovative way of ensuring participation, equity, and well-being in the community. Such an approach might be especially important in deprived areas or in multi-ethnic communities. An important prerequisite to succeed is the openness of the school’s staff to engage in co-creation with other stakeholders in the community.

On Time: A Qualitative Study of Swedish Students', Parents' and Teachers' Views on School Attendance, with a Focus on Tardiness

Tardiness is a common problem in many schools. It can be understood as an individual risk for future problematic behavior leading to absenteeism, school dropout, exclusion and later health problems. Tardiness can also be examined in relation to a broader social-ecological perspective on health. The aim of this study was to analyze students’, school staff’s and parents’ views on students’ tardiness in two Swedish schools. A focus group interview design was used with 21 school personnel, 21 students in grade nine and two parents. The data were analyzed by using thematic content analysis. The results illustrated the main theme—It depends on…—regarding what will happen if a student arrives late to school lessons. This finding is further explained by the subthemes about teachers’ signals and reactions and the responses from teachers and students. The conclusion showed the importance of organizing the school day more predictably for the students. Late arrival is a sign of shortcomings in a school organization. It is necessary to develop guidelines related to how to handle students’ late arrival based on predictable viewpoints but even more so on how to promote students’ sense of belonging and their interest in and motivation for going to school.

Positive self-reported health might be an important determinant of student's experiences of high school in northern Sweden

There is a need for more knowledge about positive health determinants in the school setting. The overall aim of this study was to analyse if positive self-reported health is associated with experiences of school among high-school students. Data originated from the health dialogue questionnaire answered by students in grade 1 of high school. A total of 5035 students participated from the academic years 2013 to 2016. Logistic regression with positive odds ratio (POR) was used to analyse associations between positive self-reported health and school experiences. There was an association between positive self-reported health and school experiences among students. Positive mental health was the strongest predictor for positive school experiences. To frequently participate in Physical Education, have a positive body image and satisfactory sleep nearly doubled the students' odds for positive school experiences. The results also revealed gender differences; boys more often reported positive experiences of school and positive health than girls. Positive self-reported health is associated with positive experiences of school, particularly mental health. Moreover, these findings have significant implications for how students experience school and demonstrate the importance of including health-promoting interventions in systemic school improvement, meeting both girls' and boys' needs.

Voices from Pupil Participation in the Health Promotion Intervention "Pulse for Learning and Health [PuLH]" in Primary and Middle School

In order to improve the learning conditions and health of schoolchildren, the Pulse for Learning and Health [PuLH] program in Sweden has introduced additional mandatory moderate to vigorous physical activity [MVPA] that lasts for 30 min three times a week. The PE teachers used a child-centered coaching approach to support all pupils. The aim of this study was to explore pupils’ perception and experience of PuLH that has been implemented in primary and middle schools in Sweden. We have taken into account children’s rights perspectives and adopted an exploratory and interpretive approach. In total, 73 pupils (34 girls, 39 boys, grades 4–9) were recruited through purposive sampling. 13 focus group interviews (n = 71) and individual interviews (n = 2) were carried out. All interviews were analyzed using qualitative content analysis. The analysis resulted in three major themes: ‘promotes academic performance and a learning school environment’, ‘promotes health and well-being’, and ‘individual and structural barriers’. From children’s perspective, the results highlight the importance of teachers and principals taking into account the interests and needs of all pupils, to have a well-planned MVPA intervention and to deal with issues regarding body ideals.

A photovoice study of school belongingness among high school students in Norway

Although high school graduation is important for living conditions and health throughout life, many students do not complete. In Norway's northern most county, Finnmark, up to 45% of students do not complete high school. Contrary to prior research that has primarily focused on causes for dropout, this study's aim was to deepen understanding of factors that support high school attendance. A strengths-based participatory approach using photovoice addressed attendance factors as perceived by seven participating students from one high school in Finnmark. Qualitative content analysis of data generated through group dialogue about participant-generated photos and individual interviews identified six factors important for students' school attendance: a supportive school environment, a good learning environment, recuperation and recreation, family and friends, goals and ambitions, and place attachment. Related aspects of a supportive environment and belongingness, where school staff made important contributions to promoting a positive environment, were essential.

Collaborating With Youth in School Health Promotion Initiatives With Photovoice

Photovoice, a community-based approach that is being embraced in school settings, can help to nurture collaborations with youth, particularly adolescents, and engage them in the development of social policy and health promotion projects. Photovoice is an approach that positions school nurses to inspire youth to take ownership of health promotion issues that directly affect them in the school and in their communities. Engaging youth in Photovoice not only allows advocates to directly work with youth but also promotes critical thinking and the exploration of topics that may not otherwise be considered. Photovoice raises awareness about issues through critical dialogue and is well suited to engage youth and provide a channel for youth to assert their voices.

Preliminary evaluation of an adolescent positive health measurement scale: a salutogenic health promotion approach

Health measurement tools typically assess indicators of poor health by identifying the absence, or presence, of disease and risk factors. This article describes development and validation of the first instrument for measurement of adolescent engagement in positive health promoting actions from a salutogenic approach. This cross-sectional study of 406 youths 14-16 years old tested the validity and reliability of the Salutogenic Wellness Promotion Scale for Adolescents (SWPS-Adol) and examined the extent to which SWPS-Adol positively correlated with and was able to predict perceived health among this population. Findings indicated that SWPS-Adol had good internal consistency (α = 0.84, subscales α = 0.70), a multi-dimensional structure (physical, emotional, social, vocational and spiritual), and was positively correlated with perceived health (r = 0.37, p < 0.001). The SWPS-Adol total score also showed significant positive correlations with the physical (p ≤ 0.001), emotional (p < 0.001), social (p < 0.001) and vocational (p < 0.039) dimensions. The more adolescents engaged in positive behaviors, the better their perceived health. The SWPS-Adol tool provides positive health data to guide adolescent health programs and health curricula, to inform health professionals and policy makers about how positive health actions enhance health and community wellness.

Advancing Nursing Research in the Visual Era: Reenvisioning the Photovoice Process Across Phenomenological, Grounded Theory, and Critical Theory Methodologies

Photovoice is a powerful research method that employs participant photography for advancing voice, knowledge, and transformative change among groups historically or currently marginalized. Paradoxically, this research method risks exploitation of participant voice because of weak methodology to method congruence. The purposes of this retrospective article are to revisit current interdisciplinary research using photovoice and to suggest how to advance photovoice by improving methodology-method congruence. Novel templates are provided for improving the photovoice process across phenomenological, grounded theory, and critical theory methodologies.

Participation and support - associations with Swedish pupils' positive health

From the perspective of salutogenesis, schools have opportunities to create supportive environments for health and well-being, but there is a need for more knowledge about positive health determinants in the school setting. The aim of this study was to analyse adolescents' self-reported positive health and its association with supportive factors in the school environment. Data was derived from a cross-sectional study in which pupils were aged 12-16 (n=1527). A positive health scale was used to examine the association of positive health with the following determinants: classroom participation; teacher support; peer support; parental support; and personal relative affluence. Data was analysed with multiple logistic regression. The results showed that positive health was associated with classroom participation and support from teachers and parents more commonly among boys than girls. All determinants were significantly associated with pupils' positive health. The conclusion is that students' positive health is strongly associated with support from the school. Classroom participation and support are major concerns for the health of pupils, and it is essential to develop these aspects of the school environment.

Using Instagram as a Modified Application of Photovoice for Storytelling and Sharing in Adolescents With Type 1 Diabetes

Photovoice is a research method developed to help communities share images as a tool for discussion of key issues. Although this may be useful to promote healthy behavior, using Photovoice in adolescents has been logistically challenging. Given adolescents' engagement in social media, our study explored the feasibility of using a photo-sharing mobile phone application, Instagram, to accomplish the principles of Photovoice. Twenty adolescents 14 to 18 years old with type 1 diabetes were asked to use Instagram to post any diabetes-related photo for 3 weeks. Individual interviews and a focus group were also offered, and recruitment and retention statistics were tracked. Of those approached (n = 47), 43% agreed to participate. Twelve were actively engaged. Shared photos were most likely to fall into the categories of diabetes care, humor, or food. Engaged participants universally reported the project to be a positive experience; however, there were technological and personal factors to consider for widespread implementation.

The Food Environment Through the Camera Lenses of 9- to 13-Year-Olds Living in Urban, Low-Income, Midwestern Households: A Photovoice Project

OBJECTIVE

To pilot Photovoice methodology with low-income, urban 9- to 13-year-olds to gain insight about their food environment and to determine whether this methodology was engaging and acceptable to them.

METHODS

Photovoice methodology was used to allow children to represent their food environment. Twenty male and 9 female, low-income, 9- to 13-year-old children participated. Quantitative photograph analysis included quantity taken and usable internal/external and social environment and healthfulness categorizations. Qualitative analysis was conducted through open coding of interview transcripts.

RESULTS

A total of 345 usable photos were taken by the children (n = 29), depicting both healthy and unhealthy foods. Four themes were identified (1) food characteristics; (2) social environment; (3) kitchen, cooking, and dining environments; and (4) food insecurity. Unhealthy food was most readily available to children. Children reported a lack of functioning kitchen equipment and multiple physical and environmental challenges to consuming a healthy diet. Food insecurity was prevalent. Food stamps and food pantries were used to fill gaps in the home food supply.

CONCLUSIONS AND IMPLICATIONS

Photovoice can be effective in engaging children in conversation about their food environment and increases understanding of their experiences with food. Photovoice can provide insight into the household food environments. This information can be used to tailor interventions to better reflect the living environment and eating behaviors in low-income populations.