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  • 1.
    Bittlingmayer, Uwe H.
    et al.
    Freiburg University of Education, Freiburg im Breisgau, Germany.
    Harsch, Stephanie
    Freiburg University of Education, Freiburg im Breisgau, Germany.
    Hertting, Krister
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Kostenius, Catrine
    Luleå University of Technology, Luleå, Sweden.
    Lindgren, Eva-Carin
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Lydell, Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Pelters, Pelle
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Health Promotion of Refugees – Empirical Evidence from Approaches in two European Countries2019In: 9th Nordic Health Promotion Research Conference: June 12 - 14 2019 at Roskilde University. Book of abstracts, 2019, p. 39-40Conference paper (Refereed)
    Abstract [en]

    The migration of many people to European countries in the last years created various challenges and evoked diverse responses. But rarely, lessons learned and good practice for health promotion interventions are exchanged between countries nor common solutions sought. In this workshop, we will shed light on the health situations of refugees in Sweden and Germany, and present four research projects regarding the health of refugees.

    Initially, we will outline the situation for refugees in the two countries generally, provide ample evidence on the health needs and particular burden of refugees, and discuss the increasing influence of racism. Finally, we will discuss the issue health promotion of refugees, needs, approaches, limitations.

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  • 2.
    Kostenius, Catrine
    et al.
    Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden.
    Hertting, Krister
    Halmstad University, School of Health and Welfare.
    Pelters, Pelle
    Department of Education, University of Stockholm, Stockholm, Sweden.
    Lindgren, Eva-Carin
    Halmstad University, School of Health and Welfare.
    From Hell to Heaven? Lived experiences of LGBTQ migrants in relation to health and their reflections on the future2022In: Culture, Health and Sexuality, ISSN 1369-1058, E-ISSN 1464-5351, Vol. 24, no 11, p. 1590-1602Article in journal (Refereed)
    Abstract [en]

    This paper explores the lived experiences of LGBTQ migrants participating in a civil society group in Sweden during the migration process and their reflections on the future. Eleven migrants who self-identified as LGBTQ (seven male/gay, one female/lesbian, one female/bi-sexual, and two transgender/gay persons) from three local support groups for LGBTQ migrants agreed to be interviewed. Participants came from Guinea, Iraq, Kurdistan, North Macedonia, Nigeria, Nicaragua, Pakistan, the Russian Federation, Syria, Uganda and Ukraine. Interpretative-phenomenological analysis resulted in three themes: Past: from daily stress to the fear of being killed; Present: safety, belonging and resources to support the transition to a new life; and Future: making a positive difference or being afraid of what’s ahead. Participants’ health-related journeys and reflections about the future were complex in terms of favourable and unfavourable lived experiences, which become resources and risks for personal development. Study findings offers an enhanced awareness of the complex landscape of, and interaction between, vulnerability and potentiality. Based on the findings, we suggest the adoption of a health promoting approach focusing on the LGBTQ migrants’ strengths and personal resources. © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

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  • 3.
    Pelters, Britta
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Sport.
    On mountains and prophets: targeting majorities to support minorities by using norm-critics in health education2018In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 13, no sup1: Equal Health, article id 1522203Article in journal (Refereed)
    Abstract [en]

    This debate article advocates for norm-critics instead of empowering coping and pedagogy of tolerance as an educational approach to mitigate stigmatization as well as blame and guilt for health-deviant minorities within the field of health disparities. Norm-critics is a way of making members of the (presumably healthy) normative majority uncover and question their healthrelated norms and raise awareness for the processes by which members of that majority re/construct images of stereotypic figures (such as “the fatso” or “the couch-potato”) with certain personal character traits which are to be condemned and, in doing so, limit the acting space of those identified as examples of those figures. The approach, its theoretical background, arguments promoting norm-critics, and some suggestions for its practical application are presented. It is concluded that norm-critics render a valuable and much needed addition to the health intervention repertoire. © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

  • 4.
    Pelters, Britta
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Sport.
    Roxberg, Åsa
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). VID Specialized University, Bergen, Norway.
    “Don’t stop believing!” From health religiosity to an equality-enhancing hermeneutic of health promotion2018In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 13, no sup1: Equal Health, article id 1555420Article in journal (Refereed)
    Abstract [en]

    Purpose: Health beliefs are usually regarded as subjective understandings of one’s health. They can, however, be re-interpreted by drawing on the understanding that the structural features of the health discourse resemble the characteristics of a religion and on the spiritual dimension of health with its possibly salutogenic influence. The applicability of the notion of“health religiosity” and its consequences for individual health promotion are explored.

    Method: Data consist of already existent semi-structured interviews. These have been reana- lyzed in a deductive-hermeneutical way by using a five-dimensional concept of religiosity as deductive template.

    Results: The concept of religiosity proved to be productive and revealed that all health dimensions in the case are infused with spiritually ennobled ideas.

    Conclusion: We conclude that, irrespective of their factual accuracy, the salutogenic potential of ennobled ideas may best be utilized by understanding them hermeneutically. An explora- tion of a narrative hermeneutic approach to individual health promotion is suggested as the merging of meaning horizons in a hermeneutic dialogue is expected to increase awareness of spiritualized aspects of health beliefs. This may mitigate healthism and health disparities. Moreover, three challenges for individual health promotion are anticipated: realizing the situation, recognizing its complexity and resisting a simplistic practical approach. © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

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  • 5.
    Pelters, Britta
    et al.
    Karolinska Institute, Huddinge, Sweden.
    Wijma, Barbro
    Linköping University, Linköping, Sweden.
    Neither a sinner nor a saint: Health as a present-day religion in the age of healthism2016In: Social Theory & Health, ISSN 1477-8211, E-ISSN 1477-822X, Vol. 14, no 1, p. 129-148Article in journal (Refereed)
    Abstract [en]

    In Western societies, religious imagery is often used in conjunction with the topic ‘health’ in this biomedicalized, healthistic time, but is that enough to qualify the structural characteristics of the presentations and practices of health as a present-day health religion? And what may be gained by adopting such a perspective? This article explores these questions by a hermeneutical rereading, using a comprehensive list of 10 religious features derived from the sociology of religion on texts describing (a) religiously charged health phenomena, (b) the interconnection between health and society and (c) health theories. The results show that health can rightfully be called a religion, with characteristics resembling Weber’s protestant work ethic, which may accelerate the formation of a new economic and health-related underclass. Viewing health from a religious angle has the potential of introducing new concepts and ideas of religious origin into the sphere of health. We believe that this introduction will facilitate and inspire new ways of thinking about health which add a ‘religious edge’ to the seeming rationality of health, that is, an emotionalized commitment to health as a dignified authority, which an understanding of health as a moral obligation hardly captures. © 2016 Macmillan Publishers Ltd.

  • 6.
    Pelters, Pelle
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Sport. Department of Education, University of Stockholm, Stockholm, Sweden.
    Right by your side? – the relational scope of health and wellbeing as congruence, complement and coincidence2021In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 16, no 1, article id 1927482Article in journal (Refereed)
    Abstract [en]

    Purpose: Although the relation between health and well-being is deemed conceptually important, it is diverse and intractable. The aim of this small-scale study is to reveal different possible relations of the concepts of health and well-being, interrelation of these relations and consequences of implied normative expectations in the relations.

    Method: Primary data originate from course literature in Swedish health education. Additional data included scientific articles and website content (collected from WHO and via Google) and were analysed with objective hermeneutics.

    Results: Congruent, complementary and coincident relations were found. In congruence, health and well-being are synonyms. Complement relations contain: “quality” with well-being as overall aim, “plurality” with health as umbrella term, “well-being as positive health”, “enhancement” with health and well-being potentially boosting each other and “subjectivity/objectivity” with objective health complemented by subjective well-being. In coincidence, health and well-being are counter-intuitively regarded unlinked, which may challenge expectations concerning health promotive activities. Independent and affiliated relations were identified.

    Conclusion: In congruence and complement, health and well-being are mostly aligned whereas in coincidence, their quality may be decoupled. In the discursive climate of second modernity, the relation of health and well-being tends to conflict and ambiguous coincidence, demanding ambiguity tolerance as key skill. © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

  • 7. Pelters, Pelle
    et al.
    Hertting, Krister
    Halmstad University, School of Health and Welfare.
    Kostenius, Catrine
    Lindgren, Eva-Carin
    Halmstad University, School of Health and Welfare.
    “This Group is Like a Home to Me:” understandings of health of LGBTQ refugees in a Swedish health-related integration intervention: a qualitative study2022In: BMC Public Health, E-ISSN 1471-2458, Vol. 22, no 1, article id 1246Article in journal (Refereed)
    Abstract [en]

    Background: When large numbers of asylum seekers immigrate to a country, civil society is encouraged to contribute to their integration. A subgroup of asylum seekers comprising lesbian, gay, bisexual, transgender, or queer (LGBTQ) refugees are specifically deemed vulnerable to developing health and integration problems due to the double stigma of being a sexual/gender minority and a refugee. The Swedish Federation for LGBTQ Rights (RFSL) is a civil societal organization that has established the support group “RFSL Newcomers,” a health-related integration intervention that targets such refugees. The aim of the present study is reconstructing the subjective understanding of health of LGBTQ refugees. Methods: Eleven participants in Newcomers and eight organizers were interviewed about LGBTQ refugees’ experiences of migrating and participating in RFSL Newcomers. Qualitative content analysis was used to reconstruct subjective understandings of health that were constructed in these narratives. As the data did not originally concentrate on exploring understandings of health, a broad theoretical approach was used as a heuristic for the analysis, which focused on the common everyday approach of conceptualizing health as wellbeing. Results: The narratives revealed three interconnected, interdependent categories of understanding health in which tensions occur between wellbeing and ill-being: belonging versus alienation, security and safety versus insecurity, and recognition versus denial. The categories contribute to an overarching theme of health as framed freedom – i.e., freedom framed by conditions of society. Conclusions: For our participants, belonging, recognition, and security/safety are conceptual elements of understanding health, not its social determinants. Thus, these understandings emphasize relational and existential meanings of health (theoretical implication). As for practical implications, the understandings of health were connected to being either inside or outside the Newcomers group and a new society, depending on whether LGBTQ refugees comply with social requirements. As a significant actor that is representative of the cultural majority and a facilitator of LGBTQ refugees’ resettlement process, RFSL provides LGBTQ refugees with crucial orientations for becoming a “good migrant” and a “good LGBTQ person,” yet a “bad bio-citizen.” Generally, organizers of interventions may enhance the effectiveness of their interventions when relational, existential, and biomedical understandings of health are all incorporated. © 2022, The Author(s).

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  • 8.
    Pelters, Pelle
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Lindgren, Eva-Carin
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Kostenius, Catrine
    Luleå University of Technology, Luleå, Sween.
    Hertting, Krister
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Room to move as room to improve? – Health-related integration interventions in civil society2019Conference paper (Refereed)
    Abstract [en]

    Migrant groups belong to one of the most vulnerable sections of society, where issues of health inequalities and integration are at stake. Civil society is often highlighted as being an important actor in the integration of newly-arrived citizens and has also been encouraged to help migrants improve their health. The aim of the study was to explore what aspects of general and health-related acculturation and health work are expressed in research into health-related integration-interventions for migrant groups provided by civil society agents. An integrative review has been conducted. By searching databases, journal websites and reference lists, ten articles could be identified. The data has been analyzed using a concept of acculturation, different approaches to health work and the health discourse as a theoretical framework. Two different accumulations of studies have been identified: an assimilation-integration spectrum and an integration-separation spectrum. The interventions in the assimilation-integration spectrum tend to promote assimilation to the host culture and to a Western view of health. Most of these interventions are driven by representatives of the host culture. The interventions in the integration-separation spectrum are characterized by a greater openness concerning home-cultural understandings of health, alongside to an appreciation of home culture in general. These interventions are mostly migrant-driven. The acculturation strategies suggested by migrant-driven organizations tend to be orientated towards integration, whereas the strategies of native-driven organizations are more orientated towards assimilation. Thus, an awareness of basic ideas and methods in health intervention work is regarded as being crucial for civil society organizations.

  • 9.
    Pelters, Pelle
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Sport. Department of Education, University of Stockholm, Stockholm, Sweden.
    Lindgren, Eva-Carin
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden.
    Kostenius, Catrine
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Division: Health and Rehabilitation, Department of Health Sciences, Luleå University of Technology, Luleå, Sweden; Norrbotten Association of Local Municipalities, Luleå, Sweden.
    Lydell, Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Hertting, Krister
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Health-related integration interventions for migrants by civil society organizations: an integrative review2021In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 16, no 1, article id 1927488Article in journal (Refereed)
    Abstract [en]

    Purpose: Migrants are a vulnerable group concerning health and integration. Civil society organizations are deemed important for the integration and health of migrants and have been encouraged to help. This study explored health and acculturation, as expressed in research into health-related integration interventions for migrant groups provided by civil society organizations.

    Methods: Databases, journal websites and reference lists were searched in an integrative review. Thirteen articles were found and analysed using concepts of health strategies/perspectives and of acculturation with regard to general and health culture.

    Results: Studies were divided between two primary spectrums: 1) assimilation-integration and 2) integration-separation spectrum. Spectrum 1 interventions tend to promote assimilation into the present host culture and into a Western view of health. They are mostly driven by representatives of the host culture. Spectrum 2 interventions are characterized by a greater openness concerning the home-culture understandings of health, alongside an appreciation of the home culture in general. They are mostly migrant-driven.

    Conclusions: The different acculturating approaches in migrant and native-driven civil society organizations call for an awareness of their guiding health and acculturation assumptions and their applied perspectives and strategies. This awareness is considered crucial in order to achieve desired health and acculturation outcomes. © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

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  • 10.
    Winterling, Jeanette
    et al.
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden & Center of Haematology, Karolinska University Hospital, Stockholm, Sweden.
    Wiklander, Maria
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Micaux Obol, Claire
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden & Stress Rehabilitation Research, Department of Clinical Sciences Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
    Lampic, Claudia
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Eriksson, Lars E
    Medical Management Center, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden & Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden & School of Health Sciences, City University London, London, United Kingdom.
    Pelters, Britta
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Sport.
    Wettergren, Lena
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Development of a Self-Help Web-Based Intervention Targeting Young Cancer Patients With Sexual Problems and Fertility Distress in Collaboration With Patient Research Partners2016In: JMIR Research Protocols, E-ISSN 1929-0748, Vol. 5, no 2, p. e60-, article id e60Article in journal (Refereed)
    Abstract [en]

    Background: The Internet should be suitable for delivery of interventions targeting young cancer patients. Young people are familiar with the technologies, and this patient group is small and geographically dispersed. Still, only few psycho-educational Web-based interventions are designed for this group. Young cancer patients consider reproductive health, including sexuality, an area of great importance and approximately 50% report sexual problems and fertility-related concerns following cancer treatment. Therefore, we set out to develop a self-help Web-based intervention, Fex-Can, to alleviate such problems. To improve its quality, we decided to involve patients and significant others as research partners. The first 18 months of our collaboration are described in this paper. The intervention will subsequently be tested in a feasibility study followed by a randomized controlled trial.

    Objective: The study aims to describe the development of a Web-based intervention in long-term collaboration with patient research partners (PRPs).

    Methods: Ten former cancer patients and two significant others participated in building the Web-based intervention, using a participatory design. The development process is described according to the design step in the holistic framework presented by van Gemert-Pijnen et al and evaluates the PRPs’ impact on the content, system, and service quality of the planned intervention.

    Results: The collaboration between the research group and the PRPs mainly took place in the form of 1-day meetings to develop the key components of the intervention: educational and behavior change content, multimedia (pictures, video vignettes, and audios), interactive online activities (eg, self-monitoring), and partial feedback support (discussion forum, tailored feedback from experts). The PRPs influenced the intervention’s content quality in several ways. By repeated feedback on prototypes, the information became more comprehensive, relevant, and understandable. The PRPs gave suggestions concerning the number of exercises and pointed out texts and pictures needing revision (eg, experienced as normative or stereotypical) to increase the persuasiveness of the program. The system quality was improved by PRPs’ feedback on design, technical malfunctions, and navigation on the website. Based on feedback about availability of professional support (technical problems and program content), the organization for support was clarified, which increased service quality. The PRPs also influenced the research project on an overall level by suggesting modifications of inclusion criteria for the RCT and by questioning the implementation plan.

    Conclusions: With suggestions and continuous feedback from PRPs, it was possible to develop a Web-based intervention with persuasive design, believed to be relevant and attractive for young persons with cancer who have sexual problems or fertility distress. In the next step, the intervention will be tested in a feasibility study, followed by an RCT to test the intervention’s effectiveness in reducing sexual problems and fertility distress.

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