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  • 1.
    Carlerby, Heidi
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Health and Social Determinants Among Boys and Girls in Sweden: Focusing on Parental Background2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The majority of Swedish boys and girls have good psychosomatic health. Despite that the risk of mental health problems such as nervousness, feeling low and sleeping difficulties has increased steadily in recent decades. Moreover, previous surveys on health and well-being indicate that boys and girls of foreign extraction in Sweden are at increased risk of ill health compared to boys and girls of Swedish background.

     

    The main aim of this thesis was to analyse health and social determinants among boys and girls of foreign extraction in Sweden. The factors explored in papers I–IV include parental background, family affluence and gender and their associations with subjective health complaints, psychosomatic problems or health risk behaviours. Other included risk factors for ill health were involvement in bullying, low participation and discrimination at school. This thesis takes an intersectional perspective, with ambitions to be able to emphasize the interplay between different power relations (i.e. gender, social class and parental background).

     

    Two sets of cross-sectional data were used. Three papers were based on the Swedish part of the World Health Organization’s Health Behaviour in School-Aged Children. The sample consisted of 11,972 children (boys n = 6054; girls n = 5918) in grades five, seven and nine from the measurement years 1997/98, 2001/02 and 2005/06. The response rate varied between 85 and 90%. About one fifth of the included children were of foreign extraction. For the fourth paper regional data from Northern Sweden were used. Boys (n = 729) and girls (n = 798) in grades six to nine answered a questionnaire in 2011 and the response rate was 80%. About 14% of the included children were of foreign extraction. Statistical methods used were chi-square test, correlation analyses, logistic regression analyses, cluster analyses and test of mediating factor.

     

    The results showed that girls of foreign background were at increased risk of subjective health complaints (SHC) and boys of mixed background were at increased risk of psychosomatic problems (PSP). Increased risk of allocation to the cluster profile of multiple risk behaviour was shown in boys and girls of mixed background, in girls of foreign background and in girls of low family affluence. Increased risk of allocation to the cluster profile of inadequate tooth brushing was shown in boys and girls of foreign background and in girls of low family affluence. General risk factors for increased risk of ill health for boys and girls in Sweden were: any form of bullying involvement, low family affluence, low participation and discrimination at school, of which the latter also was a mediating factor for ill health. Living with a single parent was a risk factor for ill health among girls.

     

    The results can function as a basis for developing health promotion programmes at schools that focus on social consequences of foreign extraction, family affluence, participation as well as health risk behaviours and gender.

  • 2.
    Carlerby, Heidi
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Hur handläggare/specialister inom etableringen definierar hälsofrämjande faktorer i möten med nyanlända: Ett delprojekt i ”Etablering med hälsoperspektiv”2016Report (Other academic)
  • 3.
    Carlerby, Heidi
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Erling, Englund
    Research and Development Centre for the County Council of Västernorrland.
    Viitasara, Eija
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Knutsson, Anders
    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.
    Risk behaviour, parental background, and wealth: a cluster analysis among Swedish boys and girls in the HBSC study2012In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, no 4, p. 368-376Article in journal (Refereed)
    Abstract [en]

    Aim: To analyse how health risk behaviours (HRB) are clustered and associated with parental background and family wealth among Swedish boys and girls.

    Methods: Data were collected from Health Behaviour in School-aged Children (HBSC),a global cross-sectional survey for 1997/98, 2001/02, and 2005/06. A total of 11,972 boys and girls in grades 5, 7, and 9 participated in the study. The pupils were categorised in subgroups according to parental background: Swedish (80.0%), mixed (10.6%), and foreign (9.4%). Cluster analyses were used to identify HRB profiles. Multinomial logistic regression analysis was used to estimate associations between cluster allocation, parental background, and family affluence.

    Results: In total 11,232 pupils were identified and allocated to five cluster profiles, half of them in the cluster profile of low-risk behaviour. The most disadvantaged cluster was multiple HRB, which was characterised by high prevalence of smoking, drunkenness, low physical activity, and high soft-drink consumption. The cluster profile of multiple HRB was associated with both mixed background and foreign background in girls and with mixed background in boys.. The cluster profile of inadequate tooth brushing was associated with foreign background in both boys and girls. The cluster profiles of multiple HRB and inadequate tooth brushing were associated with low family affluence in girls.

    Conclusions: The cluster profiles of multiple HRB and inadequate tooth brushing were associated with parental foreign extraction in boys and girls and with low family affluence in girls. Prevention programmes based on identified clusters of HRB, including consideration of impact of socio-demographic indicators, are needed.

  • 4.
    Carlerby, Heidi
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Persson, Mats
    Headquarters, Policy and Plans Department, Swedish Armed Forces.
    Officials Reflections about Health Promoting Factors among Newly Arrivals: An Introductory Analysis2017In: International Journal of Community & Family Medicine, ISSN 2456-3498, Vol. 2, no 1, article id IJCFM-124Article in journal (Refereed)
    Abstract [en]

    Background: Resulting from conflicts, millions of peoples have been forced to leave their countries of origin. In Sweden, the Employment Agency is responsible for making decisions of immigrants’ residence in municipalities and in co-operation with these allow the immigrants’ establishment in the society. Preventive interventions among migrants and refugees, and health interventions in heterogeneous populations show that increased participation in society has positive imprints on health development. A new country includes getting acquaintance with non-familiar cultures. For example, other expectations on rules of gender, sickness, and illness. Recent years the low density populated areas in northern Sweden have received a high number of refugees in comparison with their population size. The purpose of this study was to explore how officials the Employment Agency and a selection of municipalities reflect over and define health promoting factors in their meetings with newly arrived.

    Methods: All officials (N 68) in one of the four northern counties were invited to recording their reflections on health promoting factors close to their meetings with newly arrived. The officials recorded how they defined health promoting factors according to the Audit method. The data collection of experiences of importance considering health promotion and social determinants was collected by five focus group interviews with twenty-three officials.

    Results: This study showed that the officials defined access to the health care, participation in the society, and sufficient collaboration between the authorities for not losing valuable time during the establishment period as imported factors for their clients’ opportunities for health. The officials take power among males for given, while they more often reflected over lack of power among women. However, the Swedish ideal of gender as equal quite often a challenge the newly arrivals.

  • 5.
    Carlerby, Heidi
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Svanholm, Sara
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Viitasara, Eija
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Authority officials' views on health promotion and power relations among new arrivals in northern Sweden2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, p. 115-115Article in journal (Other academic)
  • 6.
    Carlerby, Heidi
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Svanholm, Sara
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Viitasara, Eija
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    How population density and type of the municipality in Sweden influences health promotion activities for newly arrivals2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, p. 146-146Article in journal (Other academic)
  • 7.
    Carlerby, Heidi
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Svanholm, Sara
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Viitasara, Eija
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Officials' reflections about health promotion and power relations among newly arrived migrants2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, p. 474-475Article in journal (Other academic)
  • 8.
    Carlerby, Heidi
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Viitasara, Eija
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Knutsson, Anders
    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.
    How Bullying Involvement is Associated with the Distribution of Parental Background and With Subjective Health Complaints Among Swedish Boys and Girls2013In: Social Indicators Research, ISSN 0303-8300, E-ISSN 1573-0921, Vol. 111, no 3, p. 775-783Article in journal (Refereed)
    Abstract [en]

    This study aimed to analyze how bullying involvement is associated with the distribution of parental background and with subjective health complaints (SHC) among Swedish boys and girls. Data were collected from the World Health Organization, Health Behavior in School-aged Children (WHO/HBSC) survey, measurement years 1997/1998, 2001/2002 and 2005/2006. A total of 11,972 boys (50.6 %) and girls (49.4 %) in grades five, seven and nine participated in the study. The adolescents were categorized in subgroups according to parental background: Swedish (80.1 %), mixed (10.5 %) and foreign(9.7 %). Multivariate logistic regressions were used to estimate remaining risk of SHC in the categories of bullying involvement. The frequencies of bullying involvement once or more were: none involved (74.8 %), victims (10.6 %), bullies (10.3 %) and bully/victims (4.4 %). Six out of ten involved in bullying were boys. Boys of foreign background were more involved as bullies compared to boys of mixed or Swedish background. Girls of foreign background were more involved in all three categories of bullying than girls of mixed or Swedish background. Increased risk of SHC was estimated among all adolescents involved in bullying, with highest OR in the category of bully/victims, OR 3.95 (CI 3.13–4.97) for the boys and OR 4.51 (CI 4.51–6.40) for the girls. The multivariate models were stable even after adjustment for socio-demographics. There are some associations between bullying involvement and parental background. Regardless of parental background, family affluence, family structure and gender, all adolescents involved in bullying are at increased risk of SHC.

  • 9.
    Carlerby, Heidi
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Viitasara, Eija
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Knutsson, Anders
    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.
    How discrimination and participation are associated with psychosomatic problems among boys and girls in northern Sweden2012In: Health, ISSN 1949-5005, Vol. 4, no 10, p. 866-872Article in journal (Refereed)
    Abstract [en]

    Background: Negative impact on health from school disturbance due to asymmetric power relations such as discrimination and offensive treatment are frequent problems among students. This study sought to analyze associations between occurrence of discrimination at school, participation and psychosomatic problems. Methods: Pupils in grades 6–9 in ten schools in a northern Swedish municipality participated in the study. The frequency of discrimination at school was measured by six items: sex; culture or ethnicity; disability; religion beliefs; sexual preferences; and any other form of discrimination. The Social and Civic Objectives Scale (SCOS) was used for an estimation of the level of participation. The pupils’ health was measured by the PsychoSomatic Problem (PSP) scale. Multivariate logistic regression models were used for estimation of increased risk of PSP. The formula Z=d/s (d)was used to test mediation. Results: Two thirds of the boys and three fourths of the girls reported occurrences of discrimination at schools (p = 0.001). Discrimination was a mediating factor between participation and PSP among boys and girls as the mediating formula Z=d/s (d) was > + 2 SD, –2.59 for boys and –39.27 for girls. Independent of each other, low participation and discrimination were associated with increased risk of PSP. Conclusion: Discrimination was a mediating factor between participation and PSP. The mediating effectwas stronger in girls than in boys. There is a need for school health promotion programsfocusing on participation in terms of democratic processes, communication and cooperation in the classroom.

  • 10.
    Carlerby, Heidi
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Viitasara, Eija
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Knutsson, Anders
    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.
    Subjective health complaints among boys and girls in the Swedish HBSC study: focussing on parental foreign background2011In: International Journal of Public Health, ISSN 1661-8556, E-ISSN 1661-8564, Vol. 56, no 5, p. 457-464Article in journal (Refereed)
    Abstract [en]

    Objective: The general aim of this study was to explore the associations between foreign extraction and subjective health complaints (SHC) among school-aged children in Sweden. Methods: Data were obtained from the global cross-sectional survey Health Behaviour in School-aged Children (HBSC), 1997/1998, 2001/2002, and 2005/2006. A total of 11,972 pupils in grades 5, 7 and 9 participated in the survey. Logistic regression analyses were used to estimate remaining risk of SHC among the subgroups of pupils. The analyses were adjusted for socio-demographic indicators, grade and measurement year. Results: Parental background: Swedish n = 9,585, mixed n = 1,263, and foreign n = 1,124. The results showed an increased risk of SHC among girls with a foreign background OR 1.27 (95% CI 1.04-1.55) compared with girls with a Swedish background and among girls in single-adult households OR 1.42 (95% CI 1.20-1.67) compared with girls in two-adult households. No such differences were shown among boys. Conclusions: A significantly increased risk of ill health remained in girls of foreign background after adjustment for socio-demographic indicators, grade and measurement year. © 2011 Swiss School of Public Health.

  • 11.
    Forsberg, Hanna
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Carlerby, Heidi
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Norstrand, Annika
    Public Health Center, Region Norrbotten, Luleå.
    Risberg, Anitha
    Luleå University of Technology, Luleå.
    Kostenius, Catrine
    Luleå University of Technology, Luleå.
    Positive self-reported health might be an important determinant of student's experiences of high school in northern Sweden2019In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 78, no 1, article id 1598758Article in journal (Refereed)
    Abstract [en]

    There is a need for more knowledge about positive health determinants in the school setting. The overall aim of this study was to analyse if positive self-reported health is associated with experiences of school among high-school students. Data originated from the health dialogue questionnaire answered by students in grade 1 of high school. A total of 5035 students participated from the academic years 2013 to 2016. Logistic regression with positive odds ratio (POR) was used to analyse associations between positive self-reported health and school experiences. There was an association between positive self-reported health and school experiences among students. Positive mental health was the strongest predictor for positive school experiences. To frequently participate in Physical Education, have a positive body image and satisfactory sleep nearly doubled the students' odds for positive school experiences. The results also revealed gender differences; boys more often reported positive experiences of school and positive health than girls. Positive self-reported health is associated with positive experiences of school, particularly mental health. Moreover, these findings have significant implications for how students experience school and demonstrate the importance of including health-promoting interventions in systemic school improvement, meeting both girls' and boys' needs.

  • 12.
    Svanholm, Sara
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Carlerby, Heidi
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Viitasara, Eija
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Authority officials' views on organisation and collaboration in health promotion for new arrivals in Sweden2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, p. 129-129Article in journal (Other academic)
  • 13.
    Svanholm, Sara
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Carlerby, Heidi
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Viitasara, Eija
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Local authority officials' collaboration in health promotion activities for newly arrived migrants2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, p. 469-470Article in journal (Other academic)
  • 14.
    Viitasara, Eija
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Svanholm, Sara
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Carlerby, Heidi
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Health promoting factors for newly arrived migrants - Experiences from rural and urban municipalities2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, p. 475-476Article in journal (Other academic)
  • 15.
    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.

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