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Ringsberg, K. C., Olander, E., Tillgren, P., Thualagant, N. & Trollvik, A. (2018). Concerns and future challenges of health literacy in the Nordic countries - From the point of view of health promotion practitioners and researchers. Scandinavian Journal of Public Health, 46(20_suppl), 107-117
Open this publication in new window or tab >>Concerns and future challenges of health literacy in the Nordic countries - From the point of view of health promotion practitioners and researchers
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2018 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 46, no 20_suppl, p. 107-117Article in journal (Refereed) Published
Abstract [en]

Background: Health literacy is an essential social determinant for promoting and maintaining the health of a population. Aim: From a health promotion perspective, explore health literacy issues, concerns and future challenges among Nordic practitioners and researchers. Methods: Data were collected in a workshop at the 8th Nordic Health Promotion Conference, and in a literature review, with articles from five databases. The search included title and abstract with the search terms health literacy* and health literacy as a MeSH term and all the Nordic countries. Qualitative and quantitative analysis were used. Results: Twenty-five persons participated in the workshop. The discussions were summarized in six themes: concept of health literacy in national language; risk of victim blaming; measuring health literacy; content in school curricula on health literacy; new technologies for information and communication; communication and collaboration between different actors in support of health. Forty-three articles on health literacy were identified, mainly conducted within three fields: development, test and adaptation of instruments for measuring health literacy; measurement of health literacy among patients, or other defined target groups and on populations; and developing and evaluating methods/tools for the training of personnel groups or different target groups. Conclusions: There is a need for further studies providing a more in-depth understanding of the health literacy concept, knowledge on how to measure health literacy, ethical aspects, application in intersectoral collaboration as well as the adaptation to new technologies for information and communication in education supporting health literacy. As health literacy is an essential social health determinant, a concern and a future challenge must be, to make the health literacy concept familiar and visible in health promotion policies, research and practice such as health education. 

Place, publisher, year, edition, pages
SAGE Publications Ltd, 2018
National Category
Health Sciences
Research subject
Public Health Sciences
Identifiers
urn:nbn:se:mdh:diva-38917 (URN)10.1177/1403494817743903 (DOI)000428758300016 ()29552970 (PubMedID)2-s2.0-85044107460 (Scopus ID)
Available from: 2018-04-05 Created: 2018-04-05 Last updated: 2019-11-15
Norfjord Van Zyl, M., Akhavan, S., Tillgren, P. & Asp, M. (2018). Experiences and perceptions about undergoing mammographic screening: a qualitative study involving women from a county in Sweden. International Journal of Qualitative Studies on Health and Well-being, 13(1), Article ID 1521256.
Open this publication in new window or tab >>Experiences and perceptions about undergoing mammographic screening: a qualitative study involving women from a county in Sweden
2018 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 13, no 1, article id 1521256Article in journal (Refereed) Published
Abstract [en]

Purpose:An organized population-based mammographic screening programme aims for an early detection of potential breast abnormalities so that treatment can commence. Continuous participation and a high attendance rate are vital for an effective programme. It is important to understand the underlying reasons for participation in mammographic screening, should there be factors that are amendable within reason and could be adjusted. Therefore, the invited women are valuable sources of information. This study aimed at describing the experiences and perceptions about mammographic screening of women from three municipalities in a Swedish county.Method:Six semi-structured focus-group discussions, each with four to five participants, were held. Content analysis was then conducted.Results:The screening procedure, such as staff professionalism, was covered. Other people's opinions and the woman's own understanding affected the women's decisions on whether or not to undergo the procedure. Structural conditions, such as travel time and financial issues, were sources of concern. However, the offer to perform mammographic screening was perceived with gratitude.Conclusions:Structural conditions, risk and time perceptions, the screening procedure, attitudes towards undergoing it and appreciation of its benefit may influence the women's continuous willingness to be screened, which in turn may affect public and individual health.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD, 2018
Keywords
Experiences, focus groups, mammographic screening, participation, perceptions, public health, qualitative study
National Category
Health Sciences Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:mdh:diva-41008 (URN)10.1080/17482631.2018.1521256 (DOI)000444566400001 ()30215571 (PubMedID)2-s2.0-85053259288 (Scopus ID)
Available from: 2018-09-27 Created: 2018-09-27 Last updated: 2019-11-15
Haglund, B. J. & Tillgren, P. (2018). Milestones in Nordic Health Promotion Research. Scandinavian Journal of Public Health, 46(20_suppl), 7-19
Open this publication in new window or tab >>Milestones in Nordic Health Promotion Research
2018 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 46, no 20_suppl, p. 7-19Article in journal (Refereed) Published
Abstract [en]

Based on the storytelling tradition and analyses of conference material, this article provides an overview of the evolving Nordic Health Promotion Research Network (NHPRN) and its conferences over the last 20 years. The story goes from the planning of the first conference in Bergen, Norway, back in 1996 to the eighth conference in Jyväskylä, Finland, in 2016. There have been three phases of development. During the first phase, 1996–2007, the five first conferences were initiated and implemented by departments of public health in the Nordic countries. The World Health Organization (WHO) collaborative centres of Health Promotion in Bergen University and a group at Karolinska Institute, Department of Social Medicine, creating supportive environments for health in Stockholm played key roles in initiating and supporting NHPRN. During the second phase, 2007–2014, the network was strengthened and supported by the Nordic School of Public Health (NHV) in Gothenburg. The third phase started when NHV closed down in 2015 and networking activities were transferred to the European Office of WHO in Copenhagen. The Nordic Health Promotion Research Conference series has served several purposes and will continue to do so. They are important Nordic meeting places, stimulating Health Promotion research, as well as explicitly managing ongoing concerns in the international Health Promotion community. This is reflected in the shift of foci over time. The content of the conferences has been highly responsive to whatever challenges are particularly relevant at different points in time, while also contributing to developing Health Promotion as a discipline, given that every conference has built on the previous ones.

Keywords
Health Promotion, research, public health, history, Nordic countries
National Category
Medical and Health Sciences
Research subject
Public Health Sciences
Identifiers
urn:nbn:se:mdh:diva-41252 (URN)10.1177/1403494817744930 (DOI)000428758300002 ()29552959 (PubMedID)2-s2.0-85044153739 (Scopus ID)
Available from: 2018-10-31 Created: 2018-10-31 Last updated: 2019-06-18Bibliographically approved
Gustafsson, G., Johansson, A. & Tillgren, P. (2017). Akademiska folkhälsoutbildningar i Sverige – en översikt. Socialmedicinsk Tidskrift, 94(3), 278-292
Open this publication in new window or tab >>Akademiska folkhälsoutbildningar i Sverige – en översikt
2017 (Swedish)In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 94, no 3, p. 278-292Article in journal (Refereed) Published
Abstract [sv]

Folkhälsovetenskap är sedan två decennier ett etablerat ämne inom den svenska högskolans alla tre utbildningsnivåer. Under åren har antalet utbildningar varierat och finns 2017 som akademisk utbildning vid 18 lärosäten. På grundnivå finns nio program och på avancerad nivå 18 olika program med vardera nio som magister- respektive masterutbildningar. Forskarutbildning i ämnet bedrivs vid tio lärosäten. Medan de varit en nedgång av antalet utbildningar på grundutbildningsnivå har det varit en kraftig utbyggnad på avancerad- och forskarutbildningsnivå. Utbildningens innehåll återspeglar väl ämnets tvärvetenskapliga karaktär och dess förankring i epidemiologi. Grundutbildningen visar på en bred inriktning och master programmen finns med flera specifika inriktningar, bland annat Global hälsa, Hälsoekonomi och Epidemiologi.

Abstract [en]

Public health science has been an established subject within Swedish universities for two decades, all three levels of higher education. Over the years, the number of courses has varied and the subject is in 2017 available at 18 universities. At the undergraduate level there are nine programmes and at advanced level 18 different programmes, with each nine as master’s (60 credits) respectively and master’s programmes (120 credits). Postgraduate studies in the subject are conducted at ten universities. While there has been a decline in the number of students at undergraduate level, there has been a vigorous expansion in advanced and postgraduate level. The content of the education clearly reflects the interdisciplinary nature of the subject and its anchoring in epidemiology. Undergraduate studies show a broad alignment and the master programmes are available with several specific foci, including Global Health, Health Economics and Epidemiology.

National Category
Medical and Health Sciences Health Sciences
Identifiers
urn:nbn:se:mdh:diva-41256 (URN)
Available from: 2018-10-31 Created: 2018-10-31 Last updated: 2018-12-13Bibliographically approved
Aytar, O., Tillgren, P., Söderlund, A., Bogg, L. & Akhavan, S. (2017). Health Care Provider’s Perceptions about and Experiences of Achieving Equitable Health Care: An Evaluation Study. Quality in Primary Care, 25(5), 289-296
Open this publication in new window or tab >>Health Care Provider’s Perceptions about and Experiences of Achieving Equitable Health Care: An Evaluation Study
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2017 (English)In: Quality in Primary Care, ISSN 1479-1072, E-ISSN 1479-1064, Vol. 25, no 5, p. 289-296Article in journal (Refereed) Published
Abstract [en]

Background: In June 2011 the Swedish government signed an agreement with The Swedish Association of Local Authorities and Regions (SALAR), for a three year project to develop and implement “Health care on equal terms.” The project, which involved seven Primary Health Care Units (PHCU) from five county councils in different parts in Sweden, was completed in early 2014. The aim of the project was to develop methods and activities that could promote more equal health care provision in socio-economically disadvantaged areas.

Aim: To assess and compare health care providers’ experiences of and perceptions about equitable health care at the beginning and end of the national project “Health care on equal terms”.

Methods: A web survey was sent to all staff at the seven participating Primary Health Care Units (PHCU) at the beginning (2012) and the end (2013) of the project. Data were analyzed with descriptive statistics and the open issues with content analysis.

Results: In 2013, the percentage of health care providers who reported thinking patients’ ethnicity had no or very little impact on access to care increased, but the proportion of those who reported that they had “no idea” that patients’ gender, age, mental health and physical functioning were significant for access to care was lower in 2013 than in 2012. The results from analysis of the open-ended questions did not show meaningful changes in the respondents’ perceptions of the issues addressed in 2012-2013, but the analysis contributes to a deeper explanation of the answers.

Conclusion: The main conclusion is that it was possible to implement changes aiming for more equitable care through projects with a focus on learning.

Place, publisher, year, edition, pages
London: , 2017
Keywords
Sweden; Primary health care providers; Equity; Health services research
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Social Work
Research subject
Care Sciences; Social Work
Identifiers
urn:nbn:se:mdh:diva-37165 (URN)
Projects
Det nationella lärandeprojektet - Vård på lika villkor
Available from: 2017-10-31 Created: 2017-10-31 Last updated: 2018-01-09Bibliographically approved
Berensson, K. & Tillgren, P. (2017). Health impact assessment (HIA) of political proposals at the local level: successful introduction, but what has happened 15 years later?. Global Health Promotion, 24(2), 43-51
Open this publication in new window or tab >>Health impact assessment (HIA) of political proposals at the local level: successful introduction, but what has happened 15 years later?
2017 (English)In: Global Health Promotion, ISSN 1757-9759, E-ISSN 1757-9767, Vol. 24, no 2, p. 43-51Article in journal (Refereed) Published
Abstract [en]

Health impact assessments (HIAs) were first introduced in Sweden in the mid-to-late 1990s, with the aim of placing health issues on the political agenda and helping to reduce health inequalities. In the early 2000s, HIAs entered a second phase and the Swedish Parliament adopted a national public health policy. A national survey conducted in 2001 showed that 10/289 municipalities had begun to use HIA and 55/289 had decided to use HIA or had initiated an adoption process. In a 2013 follow-up study based on a strategic sample of municipalities, 9/36 municipalities reported using HIA and/or similar tools. Corresponding figures for the 21 Swedish regions were 10 regions in 2001 and four in 2013. HIA and similar tools (sustainability analyses, child impact assessments, and others) were applied to the same extent as HIA. Fifteen years after implementation began, HIA is still being used. Regions show a clear decrease in the use of HIA. There are several explanations for this development. One is the political context, and other explanations are shifts in which actors are responsible for HIA and for public health at the local/regional levels.

Place, publisher, year, edition, pages
SAGE Publications Ltd, 2017
Keywords
health equity, health impact assessment, local/regional level, public health policy, Sweden, adoption, child, follow up, human, public health
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-36102 (URN)10.1177/1757975916683386 (DOI)000404418800006 ()28436297 (PubMedID)2-s2.0-85021432360 (Scopus ID)
Available from: 2017-07-12 Created: 2017-07-12 Last updated: 2018-10-16Bibliographically approved
Choowong, J., Tillgren, P. & Söderbäck, M. (2017). Thai people living with tuberculosis and how they adhere to treatment: A grounded theory study. Nursing and Health Sciences, 19(4), 436-443
Open this publication in new window or tab >>Thai people living with tuberculosis and how they adhere to treatment: A grounded theory study
2017 (English)In: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018, Vol. 19, no 4, p. 436-443Article in journal (Refereed) Published
Abstract [en]

To develop a conceptual framework of adherence to treatment among Thai people living with tuberculosis, a grounded theory approach was used. A purposive sample of 20 Thai people living with tuberculosis, aged from 23 to 85years, was interviewed. From the participants' perspective, a core category of social belonging was highlighted, with three categories of conditions connected: personal barriers, personal resilience, and social facilitation. Personal barriers encompassed fear of stigma, concealing the illness, and lack of knowledge and motivation to complete the treatment regime. Personal resilience encompassed positive thinking and self-awareness. Social facilitation encompassed the ease of access to health services, continuity in the health service's ability to choose a directly-observed therapy observer, and social support. This study contributes a deeper understanding of the perspective of Thai people living with tuberculosis with regards to adherence to tuberculosis treatment. It might improve how local healthcare workers provide tuberculosis care, and inspire them to tailor care to people living with tuberculosis in a local community to increase personal resilience and reduce stigma.

Place, publisher, year, edition, pages
WILEY, 2017
Keywords
adherence to treatment, conceptual framework, grounded theory, Thailand, tuberculosis, stigma
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-37620 (URN)10.1111/nhs.12362 (DOI)000418093100005 ()28719050 (PubMedID)2-s2.0-85025089217 (Scopus ID)
Available from: 2018-01-05 Created: 2018-01-05 Last updated: 2018-01-23Bibliographically approved
Fredén, L., Tillgren, P. & Wall, S. (2017). Vilken inriktning och kvalitet har examensarbeten i svenska folkhälsovetenskapliga utbildningar?. Socialmedicinsk tidskrift, 94(3), 293-300
Open this publication in new window or tab >>Vilken inriktning och kvalitet har examensarbeten i svenska folkhälsovetenskapliga utbildningar?
2017 (Swedish)In: Socialmedicinsk tidskrift, ISSN 0037-833Xf, Vol. 94, no 3, p. 293-300Article in journal (Refereed) Published
Abstract [sv]

Den andra nationella utvärderingen av samtliga 23 utbildningsprogram på kandidat-, magister- och masternivå i folkhälsovetenskap genomfördes 2011-2012. Här presenteras en översikt av de examensarbeten som utvärderingen baserades på. Det är 218 slumpmässigt utvalda uppsatser, 67 från kandidatnivå, 55 från magisternivå och 76 från mastersnivå. Högskoleverkets hårt reglerade format medgav inte någon innehållsmässig analys av hur folkhälsovetenskapen speglades i uppsatserna. Vi åtta i bedömargruppen var dock eniga om att vidga ramarna. Vår fördjupning kom att fokuseras på vilka tillämpningsområden som studenterna valde, vilka forskningsdesigner som tillämpades och hur kvaliteten bedömdes i relation till ämne, metod och fakultetsområde. Av de nio folkhälsovetenskapliga områden som förekommer i uppsatserna var de vanligaste Hälsofrämjande och Hälsans bestämningsfaktorer. Ämnesinnehåll och olika examensnivåer varierade stort mellan de olika lärosätena. En slutsats är att utbildningen i folkhälsovetenskap har svårigheter att balansera det flervetenskapliga med att nå ett fördjupat kunskapsinnehåll.

Keywords
folkhälsostudenter;arbetsmarknad;anställningsbarhet;kompetensutveckling
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:mdh:diva-41257 (URN)
Available from: 2018-10-31 Created: 2018-10-31 Last updated: 2018-12-11Bibliographically approved
Akhavan, S., Tillgren, P., Aytar, O., Bogg, L. & Söderlund, A. (2016). Practice and Policy in Promoting Health and Equity –experiences from a national project in primary health care in Sweden. In: : . Paper presented at 22nd IUHPE World Conference on Health Promotion, CURITIBA, BRAZIL.
Open this publication in new window or tab >>Practice and Policy in Promoting Health and Equity –experiences from a national project in primary health care in Sweden
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2016 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Introduction: The Swedish Health Care Law requires the health system to provide good care on equal terms to all. However, several reports from different governmental agencies have revealed that health care is uneven in quality, lacking in accessibility, and not offered on equal terms to all people. Recent public health reports show that inequalities in health in the population have increased. To provide health care on equal terms has become a challenge for health care.

In order to apply methods for developing practice and policy in promoting health and equity the Swedish Association of Local Authorities and Regions developed and implemented a national project entitled Care on Equal Terms. The project began in 2011 and was completed in 2014 at seven Primary Health Care Units (PHCUs) in five regions. The aim of this study was to evaluate the outcomes of this project.

Methods: Based on a program theoretical approach an evaluation design was developed which included process, results and economical evaluation. In the data collection and analysis mixed methods were applied.

Results: According to the process evaluation, seven different strategies were applied in the process to develop primary health care on equal terms. One of the key observations was that in order to achieve health on more equal terms, health care needs to be provided on unequal terms, i. e. more needs to be done to reach those who need more assistance to access health services. Health promotion was one of the applied strategies and it was the most common strategy at some of the health care centers with the aim of developing patients' knowledge, awareness and understanding about health, care and self-care. The results evaluation showed that the PHCUs staff identified structural and organizational factors in health care as important factors for developing health promotion and equity in access. The health economic evaluation showed that the costs for implementing the activities for an improved equity were limited. Yet the majority of the PHCUs thought that the detailed regulation of their financing and reporting requirements were a limitation in their work for improved equity. Four of five county councils have recently introduced a primary care provider payment system (ACG) which may not be supportive of efforts to improve equity in access.

Conclusions: It is possible to develop and maintain practices that can contribute to more equitable care and increase health care personnel’s awareness about practice and policy in promoting health and equity.

National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-30887 (URN)
Conference
22nd IUHPE World Conference on Health Promotion, CURITIBA, BRAZIL
Available from: 2016-01-29 Created: 2016-01-29 Last updated: 2016-12-22Bibliographically approved
Holmström, I. K., Stier, J., Tillgren, P. & Östlund, G. (Eds.). (2016). Samproduktionens retorik och praktik: inom hälsa och välfärd (1ed.). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Samproduktionens retorik och praktik: inom hälsa och välfärd
2016 (Swedish)Collection (editor) (Other (popular science, discussion, etc.))
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2016. p. 258 Edition: 1
National Category
Public Administration Studies Educational Sciences
Identifiers
urn:nbn:se:mdh:diva-31401 (URN)978-91-44-11482-8 (ISBN)
Available from: 2016-04-11 Created: 2016-04-11 Last updated: 2016-04-18Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-3787-1040

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