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Findings from a prospective cohort study evaluating the effects of International Health Advisors’ work on recently settled migrants’ health

Lecerof, Susanne Sundell LU ; Stafström, Martin LU ; Emmelin, Maria LU ; Westerling, Ragnar and Östergren, Per-Olof LU (2017) In BMC Public Health 17(1).
Abstract

Background: Several interventions have been carried out to tackle health inequalities between migrant groups, especially refugees, and native-born European populations. These initiatives are often address language or cultural barriers. One of them is the International Health Advisors (IHA) in Sweden; a peer education intervention aimed at providing health information for recently settled migrants. It is known that social determinants, such as educational level and access to social capital, affect health. Social determinants may also affect how health information is received and transformed into practice. The aims of this study was to a) assess the impact of the IHA on recently settled migrants’ self-reported health status, and received... (More)

Background: Several interventions have been carried out to tackle health inequalities between migrant groups, especially refugees, and native-born European populations. These initiatives are often address language or cultural barriers. One of them is the International Health Advisors (IHA) in Sweden; a peer education intervention aimed at providing health information for recently settled migrants. It is known that social determinants, such as educational level and access to social capital, affect health. Social determinants may also affect how health information is received and transformed into practice. The aims of this study was to a) assess the impact of the IHA on recently settled migrants’ self-reported health status, and received health information; b) determine the moderating role of educational level and social capital; and c) critically discuss the outcomes and suggest implications for health promotion practice. Methods: The study was designed as a prospective cohort study. A postal questionnaire translated to Arabic was sent to recently settled Iraqi migrants in eight counties in Sweden, in May 2008 and May 2010. Two of the counties were exposed to the intervention, and six were used as references. Results: The proportion of individuals who reported that they had received information on healthy diet and physical exercise was higher in the intervention group than in the non-intervention group (OR 2.31, 95% CI 1.02-5.22), after adjustments. Low social participation was negatively associated with deteriorated or unchanged health needs (OR 0.47, 95% CI 0.24-0.92). No other statistically significant differences in health outcomes could be observed between the groups. No signs of effect modification on this association by social capital or educational level could be found. Conclusions: Health information provided by the IHA increased self-reported level of knowledge on healthy diet and physical exercise. The interpretation of the observed negative association between low social participation and deteriorated or unchanged health needs is that participation was limited to one’s own social group, and therefore had limited positive influence on health seeking behaviour. The lack of measurable improvements in health status could be explained by limitations in the study, in the theoretical assumptions underlying the intervention, and in the implementation of the intervention. Further research is needed to understand success factors in health promoting interventions among recently settled migrants better.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
health communication, health information, health promotion, migrants, social capital, social determinants of health
in
BMC Public Health
volume
17
issue
1
article number
369
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85018183629
  • pmid:28454517
  • wos:000400816000003
ISSN
1471-2458
DOI
10.1186/s12889-017-4273-0
language
English
LU publication?
yes
id
252564c2-b5b2-4640-96b6-3050d01689f3
date added to LUP
2017-05-24 16:19:01
date last changed
2024-05-26 16:26:59
@article{252564c2-b5b2-4640-96b6-3050d01689f3,
  abstract     = {{<p>Background: Several interventions have been carried out to tackle health inequalities between migrant groups, especially refugees, and native-born European populations. These initiatives are often address language or cultural barriers. One of them is the International Health Advisors (IHA) in Sweden; a peer education intervention aimed at providing health information for recently settled migrants. It is known that social determinants, such as educational level and access to social capital, affect health. Social determinants may also affect how health information is received and transformed into practice. The aims of this study was to a) assess the impact of the IHA on recently settled migrants’ self-reported health status, and received health information; b) determine the moderating role of educational level and social capital; and c) critically discuss the outcomes and suggest implications for health promotion practice. Methods: The study was designed as a prospective cohort study. A postal questionnaire translated to Arabic was sent to recently settled Iraqi migrants in eight counties in Sweden, in May 2008 and May 2010. Two of the counties were exposed to the intervention, and six were used as references. Results: The proportion of individuals who reported that they had received information on healthy diet and physical exercise was higher in the intervention group than in the non-intervention group (OR 2.31, 95% CI 1.02-5.22), after adjustments. Low social participation was negatively associated with deteriorated or unchanged health needs (OR 0.47, 95% CI 0.24-0.92). No other statistically significant differences in health outcomes could be observed between the groups. No signs of effect modification on this association by social capital or educational level could be found. Conclusions: Health information provided by the IHA increased self-reported level of knowledge on healthy diet and physical exercise. The interpretation of the observed negative association between low social participation and deteriorated or unchanged health needs is that participation was limited to one’s own social group, and therefore had limited positive influence on health seeking behaviour. The lack of measurable improvements in health status could be explained by limitations in the study, in the theoretical assumptions underlying the intervention, and in the implementation of the intervention. Further research is needed to understand success factors in health promoting interventions among recently settled migrants better.</p>}},
  author       = {{Lecerof, Susanne Sundell and Stafström, Martin and Emmelin, Maria and Westerling, Ragnar and Östergren, Per-Olof}},
  issn         = {{1471-2458}},
  keywords     = {{health communication; health information; health promotion; migrants; social capital; social determinants of health}},
  language     = {{eng}},
  month        = {{04}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Public Health}},
  title        = {{Findings from a prospective cohort study evaluating the effects of International Health Advisors’ work on recently settled migrants’ health}},
  url          = {{http://dx.doi.org/10.1186/s12889-017-4273-0}},
  doi          = {{10.1186/s12889-017-4273-0}},
  volume       = {{17}},
  year         = {{2017}},
}