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通过基于社区的参与式研究了解行为变化,以促进瑞典南部社会弱势社区的口腔健康。

Understanding behavioural changes through community-based participatory research to promote oral health in socially disadvantaged neighbourhoods in Southern Sweden.

机构信息

Department of Care Science, Malmö Universitet, Malmö, Skane, Sweden

Department of Care Science, Malmö Universitet, Malmö, Skane, Sweden.

出版信息

BMJ Open. 2020 Apr 6;10(4):e035732. doi: 10.1136/bmjopen-2019-035732.

Abstract

OBJECTIVES

Inequalities in oral health have been on the rise globally. In Sweden, these differences exist not between regions, but among subgroups living in vulnerable situations. This study aims at understanding behavioural change after taking part in participatory oral health promotional activity among families living in socially disadvantaged neighbourhoods in Southern Sweden.

SETTING

The current study involved citizens from a socially disadvantaged neighbourhood in Malmö, together with actors from the academic, public and private sectors. These neighbourhoods were characterised by high rates of unemployment, crime, low education levels and, most importantly, poor health.

PARTICIPANTS

Families with children aged 7-14 years from the neighbourhood were invited to participate in the health promotional activities by a community representative, known as a health promoter, using snowball sampling. Between 8 and 12 families participated in the multistage focus groups over 6 months. Data were analysed using qualitative content analysis.

RESULTS

Three main themes emerged from the analysis, providing an understanding of the determinants for behavioural change, including meaningful social interactions, family dynamics and health trajectories. The mothers in the study valued the social aspects of their participation; however, they believed that gaining knowledge in combination with social interaction made their presence also meaningful. Further, the participants recognised the role of family dynamics primarily the interactions within the family, family structure and traditional practices as influencing oral health-related behaviour among children. Participants reported having experienced a change in general health owing to changed behaviour. They started to understand the association between general health and oral health that further motivated them to follow healthier behavioural routines.

CONCLUSIONS

The results from this study show that oral health promotion through reflection and dialogue with the communities, together with other stakeholders, may have the potential to influence behavioural change and empower participants to be future ambassadors for change.

摘要

目的

全球范围内,口腔健康不平等现象日益加剧。在瑞典,这种差异并非存在于不同地区之间,而是存在于生活在脆弱处境中的亚群之间。本研究旨在了解参与瑞典南部社会弱势社区家庭参与式口腔健康促进活动后行为的变化。

背景

本研究涉及来自马尔默社会弱势社区的公民,以及来自学术、公共和私营部门的参与者。这些社区的特点是失业率高、犯罪率高、教育水平低,最重要的是健康状况差。

参与者

通过社区代表(称为健康促进者)使用滚雪球抽样的方法,邀请该社区内 7-14 岁儿童的家庭参与健康促进活动。在 6 个月的时间里,有 8-12 个家庭参加了多阶段焦点小组。使用定性内容分析对数据进行分析。

结果

分析产生了三个主题,提供了对行为变化决定因素的理解,包括有意义的社会互动、家庭动态和健康轨迹。研究中的母亲们重视参与的社交方面;然而,她们认为获得知识与社交互动相结合,使她们的存在也具有意义。此外,参与者认识到家庭动态的作用,主要是家庭内部的互动、家庭结构和传统习俗,这些都影响了儿童的口腔健康相关行为。参与者报告称,由于行为的改变,他们的整体健康状况发生了变化。他们开始理解整体健康和口腔健康之间的关联,这进一步激励他们遵循更健康的行为习惯。

结论

本研究结果表明,通过与社区和其他利益相关者一起进行反思和对话来促进口腔健康,可能有潜力影响行为的变化,并使参与者有能力成为变革的未来大使。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a306/7245372/09b6744aea87/bmjopen-2019-035732f01.jpg

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