Crisis and Trauma Unit, Region Västra Götaland, Gothenburg, Sweden.
School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
BMC Public Health. 2021 Feb 2;21(1):262. doi: 10.1186/s12889-021-10284-z.
Research increasingly highlight post-migration factors for migrants' mental health status. We investigated the association between participation in a health promotion program and changes in migrants' mental health, and if socio-demographic factors and length of time in the new home country, Sweden, influenced a potential association.
A five-week health promotion program named 'Hälsostöd' [Health Support], led by community health workers, was offered to migrants, primarily asylum seekers and newly arrived immigrants (N = 202). The framework for the program was salutogenic psycho-education, which focused on health effects of migration experiences, lifestyle and health, and the health care system. Mental health was measured at the start and end of the program. We analysed this follow up by using the recommended clinical cut off (i.e. > 11 of maximum 36, with higher scores indicating possible mental illness) in the 12- item version of the General Health Questionnaire (GHQ12). Chi Square test was used to analyse statistical significance of changes, and multinomial logistic regression to analyse associations to sociodemographic factors and length of stay in Sweden.
The number of participants scoring above the clinical cut off after participation in the program (N = 79, 39.1%) was lower compared to the corresponding number before participation (N = 111, 55.0%), Chi Square = 10.17, p < .001. The majority of the participants had no change 72.3 (N = 146), 21.8% (N = 44) had a positive change, yet 5.9% (N = 12) had a negative change, compared to before participation in the program. None of the investigated sociodemographic factors showed to significantly influence the association. Length of stay in Sweden was trending, with participants with longer stay being more likely to have possible mental illness.
We conclude that psycho-educative programs, similar to 'Hälsostöd', have potential for promoting asylum seekers' and newly arrived immigrants' mental health as the evaluation showed a considerable number of positive changes in participants. The result suggests the importance of offering immigrants health promotive programs in close connection with arrival to the new home country. Future research should clarify under what circumstances sociodemographic factors influence the effects of such programs.
越来越多的研究强调了移民心理健康状况的后移民因素。我们调查了参与健康促进计划与移民心理健康变化之间的关系，如果社会人口因素和在新的祖国（瑞典）的时间长短影响了这种潜在的关联。
一个名为“健康支持”的五周健康促进计划，由社区卫生工作者领导，提供给移民，主要是寻求庇护者和新移民（N=202）。该计划的框架是健康促进心理教育，重点是移民经历、生活方式和健康以及医疗保健系统的健康影响。在计划开始和结束时测量心理健康。我们使用一般健康问卷（GHQ12）的 12 项版本中推荐的临床截止值（即最高 36 分中的>11 分，得分越高表示可能患有精神疾病）来分析这种随访。卡方检验用于分析变化的统计学意义，多变量逻辑回归用于分析与社会人口因素和在瑞典停留时间的关联。
参加该计划后得分高于临床截止值的参与者人数（N=79，39.1%）低于参加该计划前的相应人数（N=111，55.0%），卡方=10.17，p<0.001。大多数参与者没有变化（N=146），72.3%；21.8%（N=44）有积极变化，而 5.9%（N=12）有消极变化，与参加该计划前相比。调查的社会人口因素均未显示出显著影响关联。在瑞典的停留时间呈趋势性，停留时间较长的参与者更有可能患有精神疾病。
我们的结论是，类似“健康支持”的心理教育计划有可能促进寻求庇护者和新移民的心理健康，因为评估显示参与者中有相当数量的积极变化。结果表明，在新的祖国抵达时为移民提供健康促进计划的重要性。未来的研究应该阐明在什么情况下社会人口因素会影响此类计划的效果。
