BMC Public Health
Volume 17, Issue 1, 2017

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

Lecerof S.S.* , Stafström M. , Emmelin M. , Westerling R. , Östergen P.-O.
  • a Social Medicine and Global Health, Department of Clinical Sciences Malmoe, Lund University, Clinical Research Centre, Jan Waldenstroms gata 35, Malmoe, 205 02, Sweden
  • b Social Medicine and Global Health, Department of Clinical Sciences Malmoe, Lund University, Clinical Research Centre, Jan Waldenstroms gata 35, Malmoe, 205 02, Sweden
  • c Social Medicine and Global Health, Department of Clinical Sciences Malmoe, Lund University, Clinical Research Centre, Jan Waldenstroms gata 35, Malmoe, 205 02, Sweden
  • d Department of Public Health and Caring Sciences, Uppsala University, Uppsala, 751 22, Sweden
  • e Social Medicine and Global Health, Department of Clinical Sciences Malmoe, Lund University, Clinical Research Centre, Jan Waldenstroms gata 35, Malmoe, 205 02, Sweden

Abstract

Background: Several interventions have been carried out to tackle health inequalities between migrant groups, especially refugees, and native-born European populations. These initiatives are often address language or cultural barriers. One of them is the International Health Advisors (IHA) in Sweden; a peer education intervention aimed at providing health information for recently settled migrants. It is known that social determinants, such as educational level and access to social capital, affect health. Social determinants may also affect how health information is received and transformed into practice. The aims of this study was to a) assess the impact of the IHA on recently settled migrants’ self-reported health status, and received health information; b) determine the moderating role of educational level and social capital; and c) critically discuss the outcomes and suggest implications for health promotion practice. Methods: The study was designed as a prospective cohort study. A postal questionnaire translated to Arabic was sent to recently settled Iraqi migrants in eight counties in Sweden, in May 2008 and May 2010. Two of the counties were exposed to the intervention, and six were used as references. Results: The proportion of individuals who reported that they had received information on healthy diet and physical exercise was higher in the intervention group than in the non-intervention group (OR 2.31, 95% CI 1.02-5.22), after adjustments. Low social participation was negatively associated with deteriorated or unchanged health needs (OR 0.47, 95% CI 0.24-0.92). No other statistically significant differences in health outcomes could be observed between the groups. No signs of effect modification on this association by social capital or educational level could be found. Conclusions: Health information provided by the IHA increased self-reported level of knowledge on healthy diet and physical exercise. The interpretation of the observed negative association between low social participation and deteriorated or unchanged health needs is that participation was limited to one’s own social group, and therefore had limited positive influence on health seeking behaviour. The lack of measurable improvements in health status could be explained by limitations in the study, in the theoretical assumptions underlying the intervention, and in the implementation of the intervention. Further research is needed to understand success factors in health promoting interventions among recently settled migrants better. © 2017 The Author(s).

Author Keywords

social determinants of health Migrants Health Communication Health promotion health information Social capital

Index Keywords

prospective study social capital health promotion exercise Prospective Studies human Health Behavior middle aged social determinants of health health status Cultural Competency cultural competence Sweden Humans migrant male female questionnaire medical information theoretical model Healthy Diet organization and management social participation translating (language) human experiment migration health education Translating adult cohort analysis Transients and Migrants public health exposure

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85018183629&doi=10.1186%2fs12889-017-4273-0&partnerID=40&md5=7004ee984588c3f22fca195f54709653

DOI: 10.1186/s12889-017-4273-0
ISSN: 14712458
Cited by: 2
Original Language: English