Adapting a South African social innovation for maternal peer support to migrant communities in Sweden: a qualitative study

Implementing a social innovation for community-based peer support for immigrant mothers in Sweden: a mixed-methods process evaluation

Introduction

A South African social innovation based on peer support for mothers was contextualized in southern Sweden. The objective of the project was to support expectant women and mothers of young children in immigrant communities to access public services that would benefit maternal and child health. This study aimed to assess how the intervention was implemented, what the contextual barriers and facilitators were, and how the implementation was perceived by those who delivered and received it.

Methods

The study used mixed methods with a convergent parallel design and followed the Medical Research Council guidance on process evaluations of complex interventions. Semi-structured interviews (n = 19) were conducted with peer supporters, client mothers, and key stakeholders involved in the intervention. The qualitative data were analyzed using content analysis. Quantitative data on peer supporters' activities were collected during contacts with client mothers and were presented descriptively.

Results

The five peer supporters had 1,294 contacts with client mothers, of which 507 were first-time contacts. The reach was perceived as wide, and the dose of the intervention was tailored to individual needs. Barriers to implementation included community mistrust of social services, norms on gender roles and parenting, and funding challenges. The implementation was facilitated by the organization's reputation, network, experience, and third-sector affiliation. Peer supporters tended to prioritize linking clients to other services over the educational components of the intervention, sometimes doing more than what was originally planned. Implementation strategies used included building trust, using multiple outreach venues, using internal support structures, and providing practical assistance as an entry point to comprehensive psychosocial support. The personal connection between peer supporters and clients was highly valued, and the building of relationships enabled them to address sensitive topics. Peer supporters sometimes experienced a blurred line between professional and personal roles.

Conclusions

Peer supporters used a variety of strategies to navigate identified barriers and facilitators. Trust was central both as a contextual factor and a strategy for implementation. It is valuable to maintain a balance between flexibility and adherence to the function of peer supporters. Further research is needed to evaluate the effects of the intervention.

Migrant women's engagement in health-promotive activities through a women's health collaboration

Introduction

Social determinants of health impact health, and migrants are exposed to an inequitable distribution of resources that may impact their health negatively, leading to health inequality and social injustice. Migrant women are difficult to engage in health-promotional activities because of language barriers, socioeconomic circumstances, and other social determinants. Based on the framework of Paulo Freire, a community health promotion program was established in a community-academic partnership with a community-based participatory research approach.

Aim

The aim of this study was to describe how a collaborative women's health initiative contributed to migrant women's engagement in health promotion activities.

Materials and methods

This study was part of a larger program, carried out in a disadvantaged city area in Sweden. It had a qualitative design with a participatory approach, following up on actions taken to promote health. Health-promotional activities were developed in collaboration with a women's health group, facilitated by a lay health promoter. The study population was formed by 17 mainly Middle Eastern migrant women. Data was collected using the story-dialog method and the material was analyzed using thematic analysis.

Result

Three important contributors to engagement in health promotion were identified at an early stage of the analysis process, namely, the group forming a social network, the local facilitator from the community, and the use of social places close to home. Later in the analysis process, a connection was made between these contributors and the rationale behind their importance, that is, how they motivated and supported the women and how the dialog was conducted. This therefore became the designated themes and were connected to all contributors, forming three main themes and nine sub-themes.

Conclusion

The key implication was that the women made use of their health knowledge and put it into practice. Thus, a progression from functional health literacy to a level of critical health literacy may be said to have occurred.

An international qualitative feasibility study to explore the process of using social innovation (co-production) strategies with older people: the SAIL project

Purpose

This paper aims to present the feasibility study findings from a four-year project funded by the European Union Commission (the SAIL project, Staying Active and Independent for Longer). The funding stream was Interreg 2Seas which offers opportunities for coastal areas on both sides of the English Channel to work together on complex practical issues. The project focused on enabling older people to stay active and independent for longer using social innovation (co-production) approaches.

Design/methodology/approach

Ten pilot projects were developed, and each of the pilots worked with an academic partner to undertake a feasibility study that included 10 pilots across the four countries involved, France, Belgium, Holland and England.

Findings

This paper presents barriers and facilitators (using logic models) to the social innovation process with older people, which has wider relevance in terms of social innovation and its application.

Research limitations/implications

The findings which inform this paper are extensive, and this is a longitudinal qualitative study with much of the data collection being done using an online wiki (complemented by interviews and documentary analysis) which is a relatively new method for data collection. However, the consistency of the findings when analysed by three researchers was clear and pragmatically this complex method was required to examine complexity in the process of implementing social innovation in practice.

Practical implications

This project has enabled greater understanding of how social innovation can be applied and has highlighted contextual issues that can undermine or enable attempts to adopt the approach.

Social implications

For the 10 pilot projects generated, there were obviously important cultural and geographical differences in terms of engagement and practical implementation of social innovation. Some of which, as mentioned in this paper, are very important for the successful implementation of social innovation in a particular setting and indeed may be a strength or a barrier in terms of engaging with local people and agencies.

Originality/value

The development of logic models is a useful approach when the topic under study is complex and likely to produce a diverse set of process outcomes. The logic model focuses upon the relationships between the resources that are used to create the intervention and what is produced in terms of outcomes. Ultimately, this enables the identification of the factors that contribute to a successful intervention. Thus, in relation to this study, logic models have helped to provide an evidence-based framework that can support decision-making regarding the most effective use of limited resources to support successful social innovation processes in the future. The logic model for each area of the findings presented here can in the future be used to help implement social innovation; also, to consider how it can be improved in future research.