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  • 1.
    Gillander Gådin, Katja
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Warne, Maria
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    A participatory visual method for increased knowledge of Swedish high school girls’ wellbeing and school achievement2018Conference paper (Other academic)
  • 2.
    Gillander Gådin, Katja
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Warne, Maria
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Is gender equality an explicit issue in Swedish high schools? Results from a photovoice study with girls in a vocational program2017Conference paper (Refereed)
    Abstract [en]

    There is a contradictory picture of Swedish girls; they are talked about as academically successful and winner at the labor market, but at the same time stressed out, have low self-esteem and high as well as increasing mental health problems. The discourse as well as the gender equality politics are (Everyone sort of know) that Sweden is a gender equal society where women and men can both work and have children, take part in society and where there is (supposed to be) freedom from men’s violence against women. This is true for some girls and women, but to fully understand the challenges and possibilities to work for a gender equal society we have to add an intersectional perspective, including several different power orders. This study will focus on high school girls in a vocational program (proxy for working class) who are invited to participate because of their lack of academic success, low self-esteem and lack of belief in the future. They are participants in a photovoice study aiming at wellbeing, academic success, safety and a positive view of the future. Their suggestions for change will guide an analysis of the high school’s role in creating a gender equality supportive environment in line with the Swedish gender equality discourse.

  • 3.
    Gillander Gådin, Katja
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Warne, Maria
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Photovoice as a method for increasing Swedish high school girls' wellbeing and school achievement2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, p. 385-385Article in journal (Other academic)
  • 4.
    Lieblein, Vaiva Sunniva Deraas
    et al.
    Department of Public Health Science, Faculty of Landscape and Society, Norwegian University of Leif Sciences, Ås, Norway.
    Warne, Maria
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Huot, Suzanne
    Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver , Canada.
    Rudman, Debbie Laliberte
    School of Occupational Therapy, University of Western Ontario, London, Canada.
    Raanaas, Ruth Kersti
    Department of Public Health Science, Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway.
    A photovoice study of school belongingness among high school students in Norway2018In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 77, no 1, article id 1421369Article in journal (Refereed)
    Abstract [en]

    Although high school graduation is important for living conditions and health throughoutlife, many students do not complete. In Norway’s northern most county, Finnmark, up to 45% of students do not complete high school. Contrary to prior research that has primarilyfocused on causes for dropout, this study’s aim was to deepen understanding of factors thatsupport high school attendance. A strengths-based participatory approach using photovoiceaddressed attendance factors as perceived by seven participating students from one highschool in Finnmark. Qualitative content analysis of data generated through group dialogueabout participant-generated photos and individual interviews identified six factors importantfor students’ school attendance: a supportive school environment, a good learningenvironment, recuperation and recreation, family and friends, goals and ambitions, andplace attachment. Related aspects of a supportive environment and belongingness, where school staff made important contributions to promoting a positive environment, were essential.

  • 5.
    Maria, Warne
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Snyder, Kristen
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Quality Technology and Management, Mechanical Engineering and Mathematics.
    Gillander Gådin, Katja
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    When health in adolescents is measured as positive health2016In: The 8th Nordic Health Promotion Research Conference (NHPRC), 2016Conference paper (Other academic)
  • 6.
    Svensson, Åsa
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Warne, Maria
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Gillander Gådin, Katja
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Energy drink consumption predicts norm-breaking behavior in Swedish adolescents2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, p. 331-, article id cky214.066Article in journal (Refereed)
    Abstract [en]

    Background: The health impact of adolescents’ consumption of energy drinks (ED) has been studied; however, previous research mainly used cross-sectional data. The aim of the present study was to describe the consumption of ED in a sample of Swedish adolescents in relation to self-reported health, support and norm-breaking behavior, and to investigate the longitudinal associations between ED consumption and norm-breaking behavior.

    Methods: The study was carried out in a municipality in The North of Sweden in 2010-2011 and includes data from 1622 adolescents in grades 6-9 who completed a questionnaire in school. Frequency of ED consumption (never vs. ever) was calculated, and chi-square test and logistic regression were used to compare ED consumption with self-reported health, support and norm-breaking behavior (i.e., truancy, staying home from school to play computer games, the use of alcohol and tobacco, and not eating breakfast or lunch every school day).

    Results: Preliminary results showed that boys consumed ED more frequently than girls: 74% of boys and 54% of girls reported to ever consume ED (P < 0.001). Frequency of ED consumption was associated with several variables related to self-reported low health, low support, and norm-breaking behavior. The associations were generally stronger among girls. Furthermore, ED consumption was a predictor of norm-breaking behavior one year later, except for not eating lunch every school day and the use of alcohol (for boys). Adjusted OR ranged from 2.02 (95% CI: 1.31, 3.10) (not eating breakfast every school day) to 4.98 (95% CI: 2.34, 10.63) (staying home from school to play computer games).

    Conclusions: In this study, adolescents’ consumption of ED was associated with several undesirable conditions and behaviors. ED consumption may thus be an important target for health promotion in young people, especially since it can predict norm-breaking behavior later on.

    Key messages: Adolescents who consume ED are more likely to engage in norm-breaking behavior compared to those who never consume ED, concurrently as well as a year later. The associations between ED consumption and undesirable behaviors and conditions were stronger for girls than boys, suggesting that the relatively smaller group of girls who use ED is more vulnerable.

  • 7.
    Vinberg, Stig
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Warne, Maria
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Alcohol use among seasonal employees in SMEs at ski resorts2015In: Understanding Small Enterprises (USE) Conference 2015 'A Healthy Working Life in a Healthy Business', 2015, p. 721-728Conference paper (Refereed)
    Abstract [en]

    This paper presents results from a survey aimed at shed some light on drinking and alcohol-related problems among seasonal employees in small businesses at ski resorts. In total, 292 employees (49 % men, 51 % women) answered a questionnaire with a response rate of 46 %. The questionnaire covered areas as employment relations, social aspects, psychosocial working conditions, health, alcohol consumption and preventive measures. Results were that there are several significant differences between seasonal employed men and women. The women are younger, have more university education, work more less than full-time and in restaurants or hotels and they live outside the ski resort to a higher degree after the winter season. Concerning psychosocial working conditions, health outcomes, hazardous drinking and preventive work at the workplace there are no significant differences between the groups. Around 75 percent of both seasonal employed men and women have a hazardous drinking behavior, which is significant higher in comparison with Swedish studies of other occupational groups. Regression analyses with hazardous drinking (AUDIT) as an outcome variable showed different patterns for seasonal employed women and men, although there are also similarities between the groups. Multivariate regression analyses showed that particularly social aspects as living with other employees and having friends with heavy drinking were significantly associated with hazardous drinking. It is important to reduce the seasonal employee’s alcohol consumption behaviors by influencing attitudes towards hazardous drinking and to change the culture among this group in working life. There is also a need for developing strategies for effective workplace preventive measures and rehabilitation measures for employees with alcohol consumption problems. For small businesses it can be successful to integrate work-related alcohol problems with occupational health and safety issues.

  • 8.
    Vinberg, Stig
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Warne, Maria
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Långt hemifrån men nära till alkohol: En studie av arbetets och kontextens betydelse för riskkonsumtion hos kvinnor och män i säsongsanställning2015In: Sprickor, öppningar & krackeleringar: Nya perspektiv på arbetsmiljö / [ed] Angelika Sjöstedt Landén, Gunilla Olofsdotter, Malin Bolin, Sundsvall: Mid Sweden University , 2015, p. 157-177Chapter in book (Refereed)
  • 9.
    Warne, Maria
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Där eleverna är: Ett arenaperspektiv på skolan som en stödjande miljö för hälsa2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Health is not created in a vacuum but in the relationship between individuals and their surroundings. School is therefore an important arena for children and youth since they spend the majority of their waking hours there. Earlier research has been particularly focused on risk factors related to mental illness in children and youth, rather than what promotes and strengthens their possibilities for positive health. Through a salutogenic approach, one can obtain knowledge about factors that contribute to a supportive environment for health. In order to gain understanding of the needs and values of new generations, students need to be made a part of their studies and the development of their own everyday environment.

    The aim of the dissertation was to study school as a supportive environment for health by involving students and finding methods of studying the positive aspects of health. The aim of the articles included challenges and possibilities for using a method to increase participation, deepen the understanding about aspects that promote health and learning, with a special focus on participation and support and how positive health can be measured.

    Students in a high school were chosen to be the participants in two qualitative studies. The method of photovoice was studied through sound recordings of the students’ dialogue during their work with photovoice and their points of view as well as the teachers’ during the focus group interviews. Data was analyzed by using content analysis (Paper I). Grounded theory was used to study the students’ view of what is important to health and learning (Paper II). A survey was used to create a positive health scale and to study factors associated with health among students in grades 6-9. The survey was taken by 1527 students (52,3% girls, 47,7% boys) in grades 6-9 in schools in the municipality of Östersund. The response rate was 80%. A principal component analysis was used to adjust and validate a positive health scale for the age group 12-16 (Paper III). In order to study the association between factors that might be associated with positive health, a multiple logistic regression was chosen (Paper IV).

    The results showed that photovoice worked as a method in high school to increase participation in matters related to health and learning. However the method needed to be adjusted to the student group. Photovoice was perceived as stimulating but also challenging by both teachers and students. Critical aspects were tied to the teacher role and the democratic organization (Paper I). The students’ view of what promoted health and learning were related to treatment, personal and pedagogical support and the potential for recovery. The results also showed that students regarded school as something that creates distinction between those who perceived themselves as under or over achievers (Paper II). The positive health scale (PHS) proved to be valid for students 12-16 years old and the scale should be useful for work with systematic health promotion where the starting point is a salutogenic perspective (Paper III). Factors associated with positive health among girls and boys age 12-16 were: a perceived participation in the classroom, support from teachers and friends and support from both parents. Socioeconomic status, measured as having as much money as pupils, was shown to be independently associated with positive health (Paper IV).

    The conclusion was that important factors for a supportive environment for health were; students’ perception of and possibility to participate in the classroom and in the school’s work environment, personal support from teachers and support in their education, support from friends and conditions that permit recovery during and after school. At the same time the results showed that there are distinctions between different groups of students in relation to health and support.

    In order to develop a supportive environment for health in schools, photovoice can be used to engage students and discover unique aspects of the individual school. With the help of the positive health scale (PHS), promoting factors can be examined, which increases the possibilities for systematic health promoting work with a salutogenic perspective.

  • 10.
    Warne, Maria
    Mälardalens Högskola.
    Hälsofrämjande skola: En handbok som ger fria händer2003Book (Other (popular science, discussion, etc.))
  • 11.
    Warne, Maria
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Med våra ögon: en metodbok om photovoice2012Book (Other academic)
  • 12.
    Warne, Maria
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Danielsson, Erna
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences.
    Högberg, Lovisa
    Mid Sweden University, Faculty of Human Sciences, Department of Business, Economics and Law.
    Torget: en plats för hållbarhet ur ett socialt, ekologiskt, kulturellt och ekonomiskt perspektiv2017In: Hållbarhetens många ansikten: samtal, forskning och fantasier / [ed] Edith Andresen, Gustav Lidén, Sara Nyhlén, Sundsvall: Mid Sweden University , 2017, p. 64-71Chapter in book (Other academic)
  • 13.
    Warne, Maria
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Gillander Gådin, Katja
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Challenges when Photovoice is used as a research method in the school setting2019Conference paper (Refereed)
    Abstract [en]

    There is growing body of research about visual methods in health promotion. Photovoice (PV), a community based participatory research method, is one of these methods that being used more and more frequently in health promotion (HP) interventions and research with young people. The aim of PV is to increase empowerment and participation among vulnerable groups. PV is often used together with so-called at-risk youth in after- school settings, more seldom in the school setting, as a part of the curriculum, with youth with varied background. The purpose of this study was to highlight dilemmas and discuss challenges when photovoice was used in the school setting as a part of the curriculum. The participants were girls and school staff at a vocational program in an upper secondary school in the Northern part of Sweden. A thematic content analysis was used to analyse data from observations, student workshops, focus groups and face-to face interviews with school staff, with focus on the PV method. The result is on progress but shows challenges that needs to be handled: hierarchies limiting the dialogue, the slow pace of the process creates frustration, and finally the method is likely to reinforce previous mistrust against adults when the participants' proposals are not implemented. The conclusions is that scholars using photovoice as a research method at school need to be aware of challenges when they use PV.

  • 14.
    Warne, Maria
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Gillander Gådin, Katja
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Costenius, Catrine
    Luleå tekniska Universitet.
    Raanaas, Ruth Kjærsti
    Norges miljö- och biovetenskapliga universitet.
    Challenges and possibilities with participatory visual research methods in health promotion2018In: 10th IUHPE European Conference and International Forum for Health Promotion Research: Implementing Health Promotion inthe Life Course - User Involvementin Practice and Research / [ed] Siw Tone Innstrand, Geir Arild Espnes and Bjarne Bruun Jensen, Trondheim, 2018Conference paper (Refereed)
    Abstract [en]

    The aim of this workshop is to discuss pros andcons using participatory visual methods in health promotion research. The interest of visual research is growing and it is time to look more critical to this increasingly popular research focus. The first part of the session, we shortly introduce visual methods in health promotion by giving examples and experiences from our research. In the second part of the session, we will discuss experiences and reflections about, e.g. vulnerable groups, power relations, ethical problems and the use of photographs together with the participants. The goals for the session are to expand the dialogue about the need for high ethical standards when using visual methods in health promotion research, to share experiences and to create contact between researchers within this field.

    There is growing body of research about visual methods in health promotion and the presenting researchers have, together and separately, used participatory visual methods for data collection and participatory action research. The authors have all experience with the PhotoVoice method, developed by Wang and Burris in the late 90th, as well as other visual methods, like cell philms and drawings and participatory research. Examples from different research projects are; non verbal language of drawings and photographs in participatory visual methods when aiming at understanding children’s life worlds, young girls' experiences of daily life at school and girls' views of sexual harassment. However alongside the many opportunities there are equal number of challenges when using nonverbal arts-based research methods in order to go beyond the limits of language to capture the meaning of lived experience in a multimodal and holistic way.

  • 15.
    Warne, Maria
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Gillander Gådin, Katja
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Snyder, Kristen
    Mid Sweden University, Faculty of Human Sciences, Department of Education.
    Photovoice: An opportunity and challenge for students' genuine participation2013In: Health Promotion International, ISSN 0957-4824, E-ISSN 1460-2245, Vol. 28, no 3, p. 299-310Article in journal (Refereed)
    Abstract [en]

    It has been highlighted that youth empowerment and participationare important principles for school health promotion.Despite this fact, children and youth are rarelygiven instruments to participate or to influence their situationsand the environments in their schools. Photovoice isa method to increased empowerment and participation.Originally it was created as a community action researchmethod based on Freire’s critical pedagogy and feministtheory. The purpose of this study was to explore challengesand opportunities for applying photovoice in aschool setting to support genuine participation. Togetherwith teachers and students in an upper secondary schoolin O ¨ stersund’s municipality in the north of Sweden, thephotovoice method was field tested and modified to aclassroom situation. The teachers and the students wereinterviewed about their experiences with the method. Theresults were interpreted by content analysis and showedthat the teachers’ capability to be facilitators and the students’possibility to make a difference for the school orthe municipality were the most important factors tosucceed with photovoice. The conclusions were thatphotovoice challenges schools and society to have a betterstructure for genuine participation if youth participation isseen as valuable.

  • 16.
    Warne, Maria
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Siandinovic, Kristina
    Karolinska Institutet.
    Berman, Anne H
    Karolinska Institutet.
    Källmén, Håkan
    STAD, Centre for Psychiatry Research, Stockholm.
    Vinberg, Stig
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Risky consumption of alcohol and drugs among employees at ski resorts2017In: Nordic Studies on Alcohol and Drugs, ISSN 1455-0725, E-ISSN 1458-6126, Vol. 34, no 3, p. 201-216Article in journal (Refereed)
    Abstract [en]

    Aim: To evaluate risky consumption of alcohol and drugs among Swedish men and women who are employed at ski resorts. Methods: A cross-sectional sample of 611 employees in 48 small and medium-sized enterprises responded to a questionnaire covering alcohol and drug use, social aspects around work and working conditions. Consumption of alcohol and drugs in the study sample was compared to population data. Data were analysed using Mann–Whitney U-tests and logistic regression analyses. Results: Compared to the general population, the study group of ski resort employees had higher scores on the Alcohol Use Disorders Identification Test (AUDIT) in all age groups except 35+ for men. Regarding the Drug Use Disorders Identification Test (DUDIT) scores, only men in the 18–24 age group had higher scores compared to the general population. The prevalence of risky alcohol and drug use was higher among seasonally employed individuals; 82.9%, compared to 58.0% among other employees for alcohol; 8.3% compared to 2.8% for drugs. The regression analysis indicated that social aspects such as living together with colleagues and having co-workers/friends who are frequently inebriated were the most significant explanatory variables for explaining risk consumption of alcohol (OR 16.82 and OR 4.33). Risky use of drugs was associated with being younger (OR 0.15) and male (OR 0.86), as well as with having co-workers/friends who are frequently inebriated (OR 4.25). Conclusions: The study showed a high prevalence of risky alcohol consumption among ski resort employees compared to the general population, with higher risky drug consumption found only among younger men. Social aspects such as living with colleagues and having co-workers or friends who are often inebriated, were identified as important explanatory factors. Preventive measures should be introduced, targeting norms and work culture surrounding alcohol and drug use among ski resort employees. 

  • 17.
    Warne, Maria
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Snyder, Kristen
    Mid Sweden University, Faculty of Human Sciences, Department of Education.
    Gillander Gådin, Katja
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Adaptation and validation of a positive health scale for adolescents2014In: Social Indicators Research, ISSN 0303-8300, E-ISSN 1573-0921, Vol. 119, no 2, p. 1079-1093Article in journal (Refereed)
    Abstract [en]

    There is a demonstrated need to develop alternative approaches to measuring health from a positive health perspective in order to support systematic planning and evaluation of health promotion in schools. The Salutogenic Health Indicator Scale (SHIS) aims to measure health from a positive perspective, However, it has not been developed, or previously been tested, for use with adolescents between the ages of 12 and 16, at which age youth often exhibit a need for extra support in order to be successful in school and life. Inspired by the SHIS, we generated a Positive Health Scale (PHS) appropriate for 12-16-year-olds and determined its validity and reliability using principal component analysis (PCA). In the study, the scale was tested in a sample of 1,527 Grade 6-9 students, using PCA. The findings indicated the need to reduce the scale to nine items, which was then shown to be valid and reliable for use with both adolescent boys and adolescent girls. We conclude that the PHS can be used in systematic health promotion planning and evaluation. Communities and schools can use this scale to examine and improve health determinants in different adolescent settings.

  • 18.
    Warne, Maria
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Snyder, Kristen
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Quality Management and Mechanical Engineering.
    Gillander Gådin, Katja
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Participation and support – associations with Swedish pupils’ positive health2017In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 76, no 1, article id 1373579Article in journal (Refereed)
    Abstract [en]

    From the perspective of salutogenesis, schools have opportunities to create supportive environments for health and well-being, but there is a need for more knowledge about positive health determinants in the school setting. The aim of this study was to analyse adolescents’ self-reported positive health and its association with supportive factors in the school environment. Data was derived from a cross-sectional study in which pupils were aged 12–16 (n=1527). A positive health scale was used to examine the association of positive health with the following determinants: classroom participation; teacher support; peer support; parental support; and personal relative affluence. Data was analysed with multiple logistic regression. The results showed that positive health was associated with classroom participation and support from teachers and parents more commonly among boys than girls. All determinants were significantly associated with pupils’ positive health. The conclusion is that students’ positive health is strongly associated with support from the school. Classroom participation and support are major concerns for the health of pupils, and it is essential to develop these aspects of the school environment.

  • 19.
    Warne, Maria
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Snyder, Kristen
    Mid Sweden University, Faculty of Human Sciences, Department of Education.
    Gillander Gådin, Katja
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Promoting an Equal and Healthy Environment: Swedish Students' View of the Daily Life at School2013In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 23, no 10, p. 1354-1368Article in journal (Refereed)
    Abstract [en]

    Education is an important factor in health equity, but many students still do not complete high school. A focus on the school context rather than on individual problems might help to create a supportive environment for health and learning. In this study we explored factors that promote health and learning from the perspective of vocational and low-achieving high school students in Sweden. We used grounded theory with a constructivist orientation, informed and sensitized by the concept of salutogenesis. Students from a school in a mid-sized municipality in Sweden participated, and we collected data using the photovoice method and interviews. Students identified general factors as significant to their well-being and success in school. The main theme, "promoting driving forces for health and learning," emerged from the categories "longing to be seen by teachers," "longing for support," and "longing for recuperation."

  • 20.
    Warne, Maria
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Snyder, Kristen
    Mid Sweden University, Faculty of Human Sciences, Department of Education.
    Gillander Gådin, Katja
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    The role of participation, teachers and peers in grades 6–9: A cross-sectional questionnaire study of factors associated with pupils’ positive health in Swedish schoolsManuscript (preprint) (Other academic)
    Abstract [en]

    The influence of the school environment on pupils’ health has more often been described in terms of health problems than health. From a perspective of health promotion and salutogenesis, schools have opportunities to create supportive environments for health. From this point of departure there is a need for more knowledge about positive health determinants in the school setting. The aim of this study was to analyze adolescents’ self-reported positive health and its association with supportive factors in the school environment. Data were derived from a cross-sectional study in which pupils aged 12–16 completed a questionnaire during school hours (n= 1527). The response rate was 80%). A new positive health scale was used to examine the association with the following determinants: classroom participation, school-related support, peer support, parent support and socioeconomic status. Data were analyzed with chi-squared tests and multiple logistic regression. The results showed that positive health, participation and support from teachers and parents were more common among boys than girls. All determinants except support with homework from the school were significantly associated with pupils’ positive health. The conclusion is that schools have a great potential to enable pupils’ health. The association between support from teachers and peers and participation is a major concern for pupils’ health and it is essential develop these aspects in the school environment.

  • 21.
    Warne, Maria
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Vinberg, Stig
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Alkohol och droger bland säsongsanställda på turistorter.: Medarbetares svar på frågor om alkohol, droger, anställningsvillkor, förebyggande arbete och hälsa2015Report (Other academic)
    Abstract [sv]

    En enkätstudie om riskkonsumtionen av alkohol och droger bland anställda i olika företag i Åre genomfördes våren 2014 av Avdelningen för Hälsovetenskap, Mittuniversitetet. Denna delrapport är framtagen till styrgruppen för projektet ”Trygg i Åre - arbetsgivare mot droger”. Projektet finansieras av Folkhälsomyndigheten och beräknas pågå under 2014-2016.

     

    Enkäten besvarades av 611 personer vilket motsvarar en svarsfrekvens på cirka 47 procent. Riskkonsumtion av alkohol mättes genom frågeformuläret AUDIT (Alcohol Use Disorders Identification Test). Gränsvärde för riskkonsumtion är 8 eller däröver för män och 6 eller däröver för kvinnor på en skala mellan 0-40. Drogbruk mättes genom DUDIT (Drog Use Disorders Identification Test). Gränsvärde för drogbruk för båda könen är 1 eller däröver.

     

    Resultatet visade att i gruppen 18-24 år fanns den högsta riskkonsumtionen av både alkohol och droger. I åldersgruppen 18-24 år fanns inga skillnader mellan könen när det gällde riskbruk av alkohol medan fler män än kvinnor visade sig ha ett drogbruk. När det gäller alkoholkonsumtionen i åldersgrupperna över 34 år är mönstret att männen i nästan dubbelt så hög grad har en riskkonsumtion i jämförelse med kvinnorna. Droganvändning förekom i stort sett inte bland dem som besvarat enkäten och var över 34 år.  

     

    Riskkonsumtionen av alkohol bland män och kvinnor visade sig vara associerat till:

     

    • Bo med kollegor/vänner
    • Ej vara fast boende i Åre
    • Ha vänner som dricker sig berusade ofta
    • Arbeta i högt tempo (endast män)
    • Om företaget inte använder slumpvisa utandningstester (endast män)

    Analysen av data visade ingen association mellan de undersökta faktorerna (boende, vänner som ofta dricker sig berusade, anställningsvillkor, riskkonsumtion av alkohol) och kvinnors bruk av droger. För männens del var bruk av droger associerat till:

     

    • Ha vänner som ofta dricker sig berusade
    • Bo med kollegor/vänner
    • Vara tillfälligt anställd
    • Ha en riskkonsumtion av alkohol

    Deltagarna i studien hade möjlighet att lämna förslag på vad de ansåg att arbetsgivaren skulle kunna göra ytterligare när det gällde det alkohol- och drogförebyggande arbetet. Fem områden identifierades:

     

    • Mer kontroller
    • Mer utbildning till anställda
    • Ett förändrat förhållningssätt till alkohol
    • Bättre hjälpinsatser om problem uppdagas
    • Det är bra som det är

    Enkäten innehöll även frågor om hälsa. Resultatet visade att en stor andel av de som svarat mår bra, mätt genom en positiv hälsoskala. Cirka 60 procent rör sig ordentligt en gång i veckan eller oftare. Merparten anser sig ha en meningsfull fritid.

     

    Den insamlade enkäten innehöll fler frågor och ytterligare analyser kommer att genomföras under projekttiden.

  • 22.
    Warne, Maria
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Vinberg, Stig
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Elefanten i rummet – ett interventionsprojekt med utmaningar2017Conference paper (Refereed)
    Abstract [sv]

    Baggrund (kontekst, problembeskrivelse, problemstilling og formål)Alkohol och droger bland säsongsanställda på skidturistorter är ett problem som beskrivits i ringa omfattning. Studier visar att förekomsten av alkohol och droger är högre i denna grupp än i befolkningen generellt. Många säsongsanställda är unga och i dessa år är risken stor att en riskfylld konsumtion av alkohol och droger leder till hälsoproblem i framtiden. Arbetsgivare och företrädare för kommun och landsting uppmärksammade problemet och erhöll finansiering av Folkhälsomyndigheten 2014-2016 för att genomföra en intervention i syfte att minska alkohol och droger bland säsongsanställda. Till projektet knöts forskare på ett universitet som genom följeforskning skulle följa och utvärdera projektet. 

    Teoretisk ramme og metodeMed utgångspunkt i systemteoretiskt perspektiv, observationer och samtal under en intervention om alkohol och droger bland anställda, diskuteras aspekter av problemägande, makt, kommunikation och samarbete mellan forskare och projektägare. Vilka hinder och möjligheter finns för sammabete mellan forskning och praktik när en intervention genomförs inom ett område som också är en del av projektägarnas näringsverksamhet? 

    Hovedresultater og konklusionerProjektets olika aktörer har olika bakomliggande syften vilka ställs på sin spets när projektresultat kommuniceras externt. Forskningens akademiska frihet, att vara oberoende gentemot marknaden, kan skapa konflikt med andra aktörer som har ett ekonomiskt intresse vilket kan äventyras av att resultat publiceras. Tät kontakt mellan universitet och praktik kan till viss del minska konflikten men metoder behöver utvecklas för att i ett tidigt skede tydliggöra roller, ansvarsområden samt forskarnas akademiska frihet. 

    Betydning for videre forskning, policy eller praksisI allt större utsträckning sker en samverkan mellan forskning och praktik och universiteten får uppdrag från det omgivande samhället. Fördelen är att forskningen når ut snabbare i samhället och kan komma till användning men det behövs fler studier som visar de problem som detta samarbete också kan leda till.

  • 23.
    Warne, Maria
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Vinberg, Stig
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sun, snow, skiing, work and a lot of party – HR leaders and seasonal workers’ views on alcohol and alcohol prevention at a ski resort in Northern Sweden.2016In: Inkluderande och hållbart arbetsliv: Book of abstracts – FALF 2016, Östersund: Mittuniversitetet , 2016, p. 13-14Conference paper (Refereed)
    Abstract [en]

    Winter tourism hires thousands of young seasonal workers every year. Work, but mostly skiing and party attracts them to stay at the ski resort for four or five months.  Previous research shows that seasonal employment is associated with hazardous drinking and risk taking behaviors. Seasonal workers’ health and healthy working environment are important issues for the tourism sector. Between 2014 and 2016 the project “Safe in Åre – employer against drugs” is running with the purpose to reduce alcohol and drugs among seasonal employees.  

    A qualitative method was used to understand critical factors for alcohol prevention among seasonal workers. Twelve HR managers in tourism companies were interviewed about alcohol prevention and the role of alcohol in seasonal workers’ daily lives. The interviews were analyzed with content analysis together with one open ended questions about seasonal workers view of the companies’ alcohol- and drug prevention. The question was answered by 611 of 1313 employees.  

    The results shows that HR managers view on alcohol prevention was two-edged. They contribute to the preservation of existing alcohol norm but have policies to control soberness at work. Emerging themes were: Retention of existing alcohol norms and Alcohol-controlled working environment. But it was also a tendency of a preventive approach among some HR managers. 

    The results are in progress but the preliminary conclusion is that the double message from the manager to the seasonal workers with restrictions and control of alcohol use at work but invitations to drink in the evening is problematic and contribute to the norm of “party culture”.

  • 24.
    Warne, Maria
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Wall, Erika
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Carlerby, Heidi
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Vinberg, Stig
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Alcohol- and drug prevention among seasonal employees at a Swedish ski resort2018In: 10th IUHPE European Conference and International Forum for Health Promotion Research: Implementing Health Promotion in the Life Course - User Involvement in Practice and Research / [ed] Siw Tone Innstrand, Geir Arild Espnes and Bjarne Bruun Jensen, 2018Conference paper (Refereed)
    Abstract [en]

    Seasonal employees at ski resorts represent a high-risk population for the use of alcohol and drugs, as well as other negative lifestyle behaviours. These employees work and live in a context where the customers are on holiday and hence alcohol is used frequently. To our knowledge there is a gap in the literature regarding alcohol and drug consumption among seasonal employees. Particularly studies in the context of ski resorts are lacking. The overall purpose of our study was to evaluate a policy-based intervention at a ski resort area in Sweden. The intervention was led by a project leader together with managers from different tourism industries, the health sector, social service and police. Components in the intervention were e.g. policy development and implementation, education of managers and creation of a manager network.  In total, 48 enterprises participated. A questionnaire, concerning alcohol and drug use and social aspects, was distributed before and after the intervention. The firs questionnaire was answered by 611 (47%) respondents and 423 (34%) respondents the follow-up questionnaire after two years. In addition, five persons in the project group was interviewed after the intervention.  Based on survey data, comparisons before and after the intervention showed several positive results. The  results show a significant reduction of hazardous drinking and an  increased awareness of the companies’ alcohol- and drug policies among the employees. No significant effects on drug consumption were found. The project group reported better knowledge about alcohol and drugs. However, most important was the increased collaboration between managers in tourism industries. The intervention also resulted in new norm breaking ideas such as a sober end of the season instead of the traditional “drinking the bar dry” and managers taking employees out on hiking instead of going out for a beer.

     

    The conclusion is that seasonal tourism industries need to work with hazardous alcohol- and drug consumption from a “whole village perspective”. Successful health promotion work among seasonal employees, needs collaboration between private and public sector and should be related to cultural norms as well as working- and living conditions in the particular context, in this case the tourist resort.

  • 25.
    Warne, Maria
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Wall, Erika
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Svensson, Åsa
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Närvarande elever och positiv skolmiljö för ökat välbefinnande och måluppfyllelse i skolan: Slutrapport från forskarna i projekt Hälsofrämjande skolutveckling inom ramen för Skolverkets anslag för 2016-20172017Report (Other (popular science, discussion, etc.))
    Abstract [sv]

    Elevers närvaro i skolan är viktig både för deras kunskapsutveckling men även för deras hälsa och välmående idag och som vuxna. En betydelsefull faktor för närvaro är de sociala interaktioner som är en del av skolans vardag. Runt 20 000 elever hade 2015 olika formera av upprepad frånvaro och forskning visar att ströfrånvaro kan leda till långa perioder av frånvaro från skolan. Syftet med denna studie var att med utgångspunkt i ett pilotprojekt undersöka hur rutinerna kring rapportering och uppföljning av elevers frånvaro fungerade på två skolor i Östersunds kommun, en kommunal F–5-skola och en kommunal 6–9-skola, samt att identifiera hinder och framgångsfaktorer för elevers närvaro i skolmiljön. Erfarenheterna från projektet förväntades ge ökade kunskaper om orsaker till frånvaro och närvaro samt ge uppslag till interventioner som främjar närvaro och positiva sociala relationer i skolan. De metoder som användes var en analys av närvarorapporteringen och fokusgruppsintervjuer med elever i årskurs 9, vårdnadshavare, elevhälsopersonal på 6–9-skolan samt lärare på de två skolorna.Resultatet visar att det program som används för att rapportera närvaro på skolorna upplevs fungera bra men att det samtidigt skapar avstånd mellan vårdnadshavare och lärare. Sen ankomst och även när elever avviker från en lektion hanteras olika av olika lärare men även olika av samma lärare från gång till gång. Det finns en samstämmighet om ansvaret för elevers skolnärvaro, men eleverna upplever inte att skolan kan bidra med något om en elev inte vill gå till skolan. Det bedrivs enligt skolorna ett strukturerat arbete för likabehandling med elevhälsoplanen, och även andra strategier som syftar till ett närvarofrämjande arbete. Eleverna verkar dock inte så medvetna om det arbete som pågår utan behöver göras mer delaktiga. Relationerna mellan eleverna lyfts fram som viktiga för att främja närvaro i skolan av alla. Eleverna saknar dock en bättre relation mellan elever och lärare och ansvaret för dessa relationer kan inte ges till en annan yrkesgrupp, som till exempel fritidsledarna. Relationen mellan vårdnadshavare och skolpersonal upplevs ha brister och vårdnadshavare och skola verkar kommunicera mer digitalt än via personliga kontakter. Detta riskerar att fördjupa en frånvaroproblematik eller att tidiga signaler inte fångas upp. Också den fysiska miljön har betydelse för hur eleverna trivs på skolan. Slitna skolmiljöer och smutsiga toaletter sänder ut negativa signaler till eleverna och riskerar i sin tur att bidra till fortsatt förstörelse. Tillgång till en avkopplande miljö och återhämtning är viktiga faktorer för att främja närvaro. För ett fortsatta närvarofrämjande arbete behöver de sociala relationerna mellan framförallt elever och lärare förbättras liksom mellan vårdnadshavare och skola. Arbetet med strategier och bemötande kring sen ankomst och närvaro i klassrummet behöver utvecklas.

  • 26.
    Warne, Maria
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Wall, Erika
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Vinberg, Stig
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Managers’ and employees’ views of critical aspects for alcohol abuse prevention at small and medium enterprises: the case of ski resorts in NorthernSweden2017In: Society, health and vulnerability, E-ISSN 2002-1518, Vol. 8, no sup1, p. 67-79, article id UNSP 1355719Article in journal (Refereed)
    Abstract [en]

    Seasonal workers at tourism resorts, particularly young employees, represent a high-riskpopulation for alcohol abuse and other negative lifestyles. This study explores how managers and employees at ski resorts in Northern Sweden experience critical aspects for hazardous alcohol use at small- and medium-sized enterprises. This analysis is based on one open-ended question about hazardous alcohol use prevention at the workplace answered by 153 employees,and semi-structured interviews about being a manager at a ski resort conducted with 13managers. The analysis showed that managers’ views regarding hazardous alcohol use prevention were double-edged, which was confirmed by the employees’ answers. The managers contribute to the preservation of existing alcohol norms but simultaneously enforce policies and administer tests to control employees’ sobriety at work. Three themes emerged: reproducing existing alcohol norms, an alcohol-controlled working environment and care-taking managers. The results identified a need for early prevention initiatives focusing on the norms and work cultures of small- and medium-sized ski resorts. In relation to the theory of planned behaviour, the analysis illuminates how evaluations of behaviours related to alcohol consumption are communicated in policies and through leadership. In addition, the importance of social pressure regarding alcohol use is clarified in the material.

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