Exploring targeted preventive health checks in a socially disadvantaged neighborhood in Denmark

2019 ◽  
Vol 35 (5) ◽  
pp. 1150-1158
Author(s):  
Anne Møller ◽  
Camilla Hoffmann Merrild

Abstract Recently studies have focused on how health promotion interventions sometimes sideline issues of social context, framing health as a matter of individual choice and, by implication, a personal responsibility. Part of this criticism is that health promotion interventions often do not draw on situated understandings of the contextual aspects of health and illness practices. Theoretically, this study departs in practice theory and contemporary public heath discussions on targeted health promotion. Based on semi-structured interviews with 18 people living in a social housing association we explored the significance of participating in a preventive health check and how participation configured into everyday life. All participants in our study had been identified with a ‘risk’ health profile. Overall, we found that they were well aware of their health risks and challenges, and that they reflected a great deal on how their health status was intrinsically linked with their lifestyle and health practices, such as lack of exercise or smoking. The health checks were, however, not able to support or improve their general health, and did not seem to address the challenges the participants seemed to struggle with in life. By way of conclusion, we suggest that we implement a more practice-oriented form of public health that focus on the ‘lives’ that people live, and the problems that they face. Moreover, attention should be paid to how and to whom health promotion initiatives are offered, in order to ensure the relevance of targeted interventions.

2018 ◽  
Vol 20 (1) ◽  
pp. 75
Author(s):  
Ursula Trummer ◽  
Sonja Novak-Zezula

The current research note describes a process where by applying the qualitative method of expert interviews, researchers got confronted with a new topic in their area of expertise that was not on the radar of their research. In the framework of an evaluation study on health promotion interventions for migrants in an urban setting, researchers applied a mixed methods approach. Quantitative element was a self-assessment tool, where providers of health promotion measures described their clientele and rated the quality of their services along given categories. Qualitative element was a series of semi-structured interviews with management and front line service providers. While the self-assessment tool delivered expected results, the interviews revealed an aspect concerning needs and problems of a migrant group researchers had not thought of before. This is the group of immigrants from the 1960ies, coming mainly from Turkey and Former Yugoslavia, now reaching or having reached retirement age. This group was reported as being extremely vulnerable and at risk of a double discrimination as being “old” and “migrant”. Desk research was conducted in reaction to such data, showing that information on this group is scarce. Given the demographic developments with rising shares of (old) aged immigrants living in Austria, it will be important to improve the respective knowledge base.


2020 ◽  
Author(s):  
Johann Cailhol ◽  
Nichola Khan

Abstract Background Seine-Saint-Denis is a deprived departement (French administrative unit) in the North-East of Paris, France, hosting the majority of South Asian migrants in France. In recent years, the number of migrants from Pakistan, which has a high prevalence of hepatitis C globally, increased. As a corollary, this study addressed the high proportion of Pakistani patients in the infectious diseases clinic of a local hospital, diagnosed with hepatitis C, but also hepatitis B and Human Immunodeficiency Virus (HIV). It explored genealogies and beliefs about hepatitis and HIV transmission, including community, sexual and blood risk behaviours. The aim was to understand the ways these risk factors reduce or intensify both en route and once in France, in order to devise specific forms of community health intervention. Methods The study took place at Avicenne University-Hospital in Seine-Saint-Denis, and its environs, between July and September 2018. The design of the study was qualitative, combining semi-structured interviews, a focus group discussion, and ethnographic observations. The sample of Pakistani participants were selected from those followed-up for chronic hepatitis C, B, and/or HIV at Avicenne, and who had arrived after 2010 in Seine-Saint-Denis. Results Thirteen semi-structured interviews were conducted, until saturation was reached. All participants were men from rural Punjab province. Most took the Eastern Mediterranean human smuggling route. Findings suggest that vulnerabilities to hepatitis and HIV transmission, originating in Pakistan, are intensified along the migration route and perpetuated in France. Taboo towards sexuality, promiscuity in cohabitation conditions, lack of knowledge about transmission were amongst the factors increasing vulnerabilities. Participants suggested a number of culturally-acceptable health promotion interventions in the community, such as outreach awareness and testing campaigns in workplaces, health promotion and education in mosques, as well as web-based sexual health promotion tool to preserve anonymity. Conclusions Our findings highlight the need to look at specific groups at risk, related to their countries of origin. In-depth understandings of such groups, using interdisciplinary approaches such as were employed here, can allow for culturally adapted, tailored interventions. However, French colour-blind policies do not easily permit such kinds of targeted approach and this limitation requires further debate.


Author(s):  
Niamh Bergin ◽  
Noel Richardson

Summary Men with the poorest health outcomes are, paradoxically, the least likely to access health services or to engage with health promotion interventions. This has focused attention on developing gender-sensitive and strengths-based approaches to engage so-called ‘hard-to-reach’ men. Men’s Sheds (‘Sheds’) are recognized as an alternative space in which to engage older and more marginalized groups of men in health. The aim of this study was to establish key principles that could align the ethos of Sheds with a national health promotion initiative (‘Sheds for Life’; SFL) in terms of methods of engagement, programme content and models of delivery. Qualitative methods incorporating semi-structured interviews, focus groups and observations were conducted with men in Sheds (‘Shedders’; n = 38), oversight/advisory groups (n = 11) and partner organizations (n = 8). The principles of grounded theory were used to inform data collection and analysis. Findings revealed a range of mediating factors in terms of how Shedders engage with or ‘do’ health that were grounded in a recognition of the health-enhancing ‘essence’ of Sheds and in ‘making men’s health men’s business’. Key learnings arising from the process of engaging with Shedders included the importance of investing in relationships, establishing credibility and tailoring SFL programme content and delivery to individual Sheds. In terms of conceptualizing SFL, attention was drawn to the need for a coherent and formalized SFL strategy and ‘rules of engagement’, as well as a robust and sustainable system for implementation. This is the first study that informs a more systematic and formal approach to health promotion in Sheds.


Author(s):  
Djoeke van Dale ◽  
Lidwien Lemmens ◽  
Marieke Hendriksen ◽  
Nella Savolainen ◽  
Péter Nagy ◽  
...  

The burden of chronic disease in Europe continues to grow. A major challenge facing national governments is how to tackle the risk factors of sedentary lifestyle, alcohol abuse, smoking, and unhealthy diet. These factors are complex and necessitate intersectoral collaboration to strengthen health promotion, counter-act the social determinants of health, and reduce the prevalence of chronic disease. European countries have diverse intersectoral collaboration to encourage health promotion activities. In the Joint Action CHRODIS-PLUS success factors for intersectoral collaboration within and outside healthcare which strengthen health promotion activities were identified with a mixed method design via a survey of 22 project partners in 14 countries and 2 workshops. In six semi-structured interviews, the mechanisms underlying these success factors were examined. These mechanisms can be very context-specific but do give more insight into how they can be replicated. In this paper, 20 health promotion interventions from national programs in CHRODIS PLUS are explored. This includes community interventions, policy actions, integrated approaches, capacity building, and training activities. The interventions involved collaboration across three to more than six sectors. The conclusion is a set of seven recommendations that are considered to be essential for fostering intersectoral collaboration to improve health-promoting activities.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Johann Cailhol ◽  
Nichola Khan

Abstract Background Seine-Saint-Denis is a deprived departement (French administrative unit) in the North-East of Paris, France, hosting the majority of South Asian migrants in France. In recent years, the number of migrants from Pakistan, which has a high prevalence of hepatitis C globally, increased. As a corollary, this study addressed the high proportion of Pakistani patients in the infectious diseases clinic of a local hospital, diagnosed with hepatitis C, but also hepatitis B and Human Immunodeficiency Virus (HIV). It explored genealogies and beliefs about hepatitis and HIV transmission, including community, sexual and blood risk behaviours. The aim was to understand the ways these risk factors reduce or intensify both en route and once in France, in order to devise specific forms of community health intervention. Methods The study took place at Avicenne University-Hospital in Seine-Saint-Denis, and its environs, between July and September 2018. The design of the study was qualitative, combining semi-structured interviews, a focus group discussion, and ethnographic observations. The sample of Pakistani participants was selected from those followed-up for chronic hepatitis C, B, and/or HIV at Avicenne, and who had arrived after 2010 in Seine-Saint-Denis. Results Thirteen semi-structured interviews were conducted, until saturation was reached. All participants were men from rural Punjab province. Most took the Eastern Mediterranean human smuggling route. Findings suggest that vulnerabilities to hepatitis and HIV transmission, originating in Pakistan, are intensified along the migration route and perpetuated in France. Taboo towards sexuality, promiscuity in cohabitation conditions, lack of knowledge about transmission were amongst the factors increasing vulnerabilities. Participants suggested a number of culturally-acceptable health promotion interventions in the community, such as outreach awareness and testing campaigns in workplaces, health promotion and education in mosques, as well as web-based sexual health promotion tools to preserve anonymity. Conclusions Our findings highlight the need to look at specific groups at risk, related to their countries of origin. In-depth understandings of such groups, using interdisciplinary approaches such as were employed here, can allow for culturally adapted, tailored interventions. However, French colour-blind policies do not easily permit such kinds of targeted approach and this limitation requires further debate.


2009 ◽  
Vol 6 (5) ◽  
pp. 578-588 ◽  
Author(s):  
Catherine E. Draper ◽  
Tracy L. Kolbe-Alexander ◽  
Estelle V. Lambert

Background:The Community Health Intervention Programmes (CHIPs) is a physical activity-based health promotion program operating in disadvantaged communities in the Western Cape, South Africa with primary school learners, adults and senior adults. Program growth, anecdotal evidence and experience of those involved suggest the program has been positively received by communities. The aim of this study was to conduct a qualitative, retrospective process evaluation concerning both factors associated with successful implementation of the programs, and implementation challenges.Methods:‘Success’ was defined in consultation with CHIPs staff and stakeholders. Data were gathered through naturalistic observation, structured interviews and focus groups (n = 104), and open-ended questionnaires (n = 81). The sample included CHIPs staff and stakeholders, program members and leaders.Results:Factors contributing to the program’s success include: focus on combining social development and exercise science, community development model, scientifically sound program content, appropriate activities, intrapersonal and interpersonal factors, program leadership, encouraging staff, and various contextual factors.Conclusions:The findings confirm that CHIPs presents a model of sustainable implementation of physical activity in disadvantaged communities, and that it positively impacts the quality of life, perceptions of the role of physical activity in health, and personal responsibility for health of those involved in its programs.


2019 ◽  
Vol 27 (3) ◽  
pp. 103-112 ◽  
Author(s):  
Dave A. Bergeron ◽  
Lise R. Talbot ◽  
Isabelle Gaboury

Background: Intersectoral oral health promotion entails the participation of local communities. IOHP interventions were introduced in Peru in primary schools in 2013 but oral health among schoolchildren living in rural Andean communities remains suboptimal. Objectives: To understand the contextual elements and the underlying mechanisms associated with intersectoral oral health promotion interventions’ current effects on schoolchildren living in remote rural Andean communities. Method: A realist evaluation was carried out in three rural Andean communities where intersectoral oral health promotion interventions aimed at schoolchildren have been implemented. Following an evaluation of the effects among schoolchildren, contextual elements and mechanisms were explored with various stakeholders involved in intersectoral oral health promotion through focus groups and semi-structured interviews. Subsequently, an iterative data analysis and a validation process resulted in the identification of context-mechanism configurations. Results: Previous positive experiences of collaboration, a focus on communication, feelings of being respected and considered, and development of leadership and trust among stakeholders involved in intersectoral oral health promotion were elements of configurations that positively influence intersectoral oral health promotion. On the other hand, unfavorable physical, social and political environments, previous negative health experiences, feelings of not being respected or considered, demotivation, development of mistrust and insufficient leadership were shown to negatively influence outcomes. Conclusion: This research highlights the complexity associated with the deployment of intersectoral oral health promotion interventions in rural communities. Local stakeholders should be further involved to build trust, to facilitate coordination processes among remote rural communities and oral health professionals, and to optimize deployment of intersectoral oral health promotion interventions.


2020 ◽  
Author(s):  
Johann Cailhol ◽  
Nichola Khan

Abstract BackgroundSeine-Saint-Denis is a deprived departement (French administrative unit) in the North-East of Paris, France, hosting the majority of South Asian migrants in France. In recent years, the number of migrants from Pakistan, which has a high prevalence of hepatitis C globally, increased. As a corollary, this study addressed the high proportion of Pakistani patients in the infectious diseases clinic of a local hospital, diagnosed with hepatitis C, but also hepatitis B and Human Immunodeficiency Virus (HIV). It explored genealogies and beliefs about hepatitis and HIV transmission, including community, sexual and blood risk behaviours. The aim was to understand the ways these risk factors reduce or intensify both en route and once in France, in order to devise specific forms of community health intervention.MethodsThe study took place at Avicenne University-Hospital in Seine-Saint-Denis, and its environs, between July and September 2018. The design of the study was qualitative, combining semi-structured interviews, a focus group discussion, and ethnographic observations. The sample of Pakistani participants were selected from those followed-up for chronic hepatitis C, B, and/or HIV at Avicenne, and who had arrived after 2010 in Seine-Saint-Denis.ResultsThirteen semi-structured interviews were conducted, until saturation was reached. All participants were men from rural Punjab province. Most took the Eastern Mediterranean human smuggling route. Findings suggest that vulnerabilities to hepatitis and HIV transmission, originating in Pakistan, are intensified along the migration route and perpetuated in France. Taboo towards sexuality, promiscuity in cohabitation conditions, lack of knowledge about transmission were amongst the factors increasing vulnerabilities. Participants suggested a number of culturally-acceptable health promotion interventions in the community, such as outreach awareness and testing campaigns in workplaces, health promotion and education in mosques, as well as web-based sexual health promotion tool to preserve anonymity. ConclusionsOur findings highlight the need to look at specific groups at risk, related to their countries of origin. In-depth understandings of such groups, using interdisciplinary approaches such as were employed here, can allow for culturally adapted, tailored interventions. However, French colour-blind policies do not easily permit such kinds of targeted approach and this limitation requires further debate.


2020 ◽  
Author(s):  
Johann Cailhol ◽  
Nichola Khan

Abstract Background Seine-Saint-Denis is a deprived departement (French administrative unit) in the North-East of Paris, France, hosting the majority of South Asian migrants in France. In recent years, the number of migrants from Pakistan, which has a high prevalence of hepatitis C globally, increased. As a corollary, this study addressed the high proportion of Pakistani patients in the infectious diseases clinic of a local hospital, diagnosed with hepatitis C, but also hepatitis B and Human Immunodeficiency Virus (HIV). It explored genealogies and beliefs about hepatitis and HIV transmission, including community, sexual and blood risk behaviours. The aim was to understand the ways these risk factors reduce or intensify both en route and once in France, in order to devise specific forms of community health intervention. Methods The study took place at Avicenne University-Hospital in Seine-Saint-Denis, and its environs, between July and September 2018. The design of the study was qualitative, combining semi-structured interviews, a focus group discussion, and ethnographic observations. The sample of Pakistani participants were selected from those followed-up for chronic hepatitis C, B, and/or HIV at Avicenne, and who had arrived after 2010 in Seine-Saint-Denis. Results Thirteen semi-structured interviews were conducted, until saturation was reached. All participants were men from rural Punjab province. Most took the Eastern Mediterranean human smuggling route. Findings suggest that vulnerabilities to hepatitis and HIV transmission, originating in Pakistan, are intensified along the migration route and perpetuated in France. Taboo towards sexuality, promiscuity in cohabitation conditions, lack of knowledge about transmission were amongst the factors increasing vulnerabilities. Participants suggested a number of culturally-acceptable health promotion interventions in the community, such as outreach awareness and testing campaigns in workplaces, health promotion and education in mosques, as well as web-based sexual health promotion tool to preserve anonymity. Conclusions Our findings highlight the need to look at specific groups at risk, related to their countries of origin. In-depth understandings of such groups, using interdisciplinary approaches such as were employed here, can allow for culturally adapted, tailored interventions. However, French colour-blind policies do not easily permit such kinds of targeted approach and this limitation requires further debate.


2013 ◽  
Author(s):  
Erin K. Tagai ◽  
Cheryl L. Holt ◽  
Mary Ann Scheirer ◽  
Sherie Lou Z. Santos ◽  
Nancy Atkinson ◽  
...  

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