Adapting a Parental Support App to Promote Healthy Diet and Physical Activity Behaviors (MINISTOP) for a Multi-Ethnic Setting: A Qualitative Study on the Needs and Preferences of Parents and Nurses within Swedish Child Health Care.

Early efforts for prevention of childhood overweight and obesity are needed. In order to adapt an app promoting healthy diet and physical activity behaviors in children (MINISTOP 1.0) for multi-ethnic communities, we explored: (1) needs and concerns among Somali-, Arabic-, and Swedish-speaking parents in terms of supporting healthy diet and activity behaviors in their children; (2) nurses' perceptions of parental needs and concerns in relation to diet and physical activity behaviors; and (3) how the features and content of the MINISTOP 1.0 app could be refined to better support health behaviors in children, among both parents and nurses. Focus groups with Somali-, Arabic-, and Swedish-speaking parents (n = 15), and individual interviews with nurses (n = 15) were conducted. Parents expressed several challenges in supporting children's health behaviors, the need for a tailored app, and alternative ways of accessing the content (audio/video). Nurses emphasized the need of supporting parents early, and the value of a shared platform in different languages, to facilitate communication. This study contributes valuable insights about parental needs and relevant adaptations to a parental support app, such as addition of audio/video files for increased accessibility. This adapted app version-MINISTOP 2.0, can be useful for childhood obesity prevention in multi-ethnic communities.

The Need for an Evidence-Based Program in Sweden to Support Parents to Create Healthy Lifestyle Behaviors from the Start of Life-Parental Perceptions.

In Sweden, there have been no interventions promoting the development of healthy lifestyle behaviors starting in infancy. Thus this paper aims to: (i) investigate Swedish parents' experiences regarding feeding of solid foods, screen time, and physical activity in healthy infants; (ii) investigate parents' needs and perceptions regarding information/support provided in primary child healthcare (CHC) and (iii) explore whether a parenting program focused on child diet and active play would be relevant and utilized. Semi-structured interviews were conducted with 20 parents. These were recorded, transcribed verbatim and analyzed using thematic analysis. Seven themes emerged: Feeling excited to enter a new phase; Parents' responsibility of doing it "right" can be stressful; Motivated to learn during specific time windows; Information to trust; The importance of social support from peers; Experiences of support received from CHC; and the Infant, Feeding, Activity, and Nutrition Trial (INFANT) for a Swedish context. Parents were excited to enter new phases in their child's development. However, this came with worry they were doing things "right", leading parents to want more information/support. Overall, Swedish parents were very positive about the prospects of engaging in a primary CHC delivered program to support them to promote healthy lifestyle behaviors from birth and felt this could complement the care currently provided.

Does the quality of encounters affect return to work? Lay people describe their experiences of meeting various professionals during their rehabilitation process.

BACKGROUND: Among the many aspects of the rehabilitation process that may be relevant for its outcome, the impact of encounters with various professionals has received little attention. OBJECTIVE: The objective was to gain a deeper understanding of how individuals with experiences of being on sick leave perceive their encounters with professionals, and how such encounters affected their ability to return to work, as well as their attitudes towards the sickness insurance system. METHODS: An inductive qualitative approach was used to analyze data from 20 interviews with men and women, aged 33-59, in Sweden who had experience of being on sick leave for at least 28 days. RESULTS: The study shows how interviewees encounters with professionals affected their self-confidence and perception of their ability to return to work. Professionals' treatment of people on sick leave seems to be affected by the structural prerequisites for offering support, where sickness insurance regulations are suggested to have a large impact. CONCLUSIONS: An encouraging and supportive attitude on the part of the professionals is essential for empowering people to handle obstacles during the rehabilitation process; whereas feeling rejected and belittled in the return to work process may lead to disempowerment, and/or delays in measures and longer periods on sick leave.

Implementation of standardized time limits in sickness insurance and return-to-work: experiences of four actors.

PURPOSE: In 2008, time limits were introduced in Swedish sickness insurance, comprising a pre-defined schedule for return-to-work. The purpose of this study was to explore experienced consequences of these time limits. Sick-listed persons, physicians, insurance officials and employers were interviewed regarding the process of sick-listing, rehabilitation and return-to-work in relation to the reform. METHOD: The study comprises qualitative interviews with 11 sick-listed persons, 4 insurance officials, 5 employers and 4 physicians (n = 24). RESULTS: Physicians, employers, and sick-listed persons described insurance officials as increasingly passive, and that responsibility for the process was placed on the sick-listed. Several ethical dilemmas were identified, where officials were forced to act against their ethical principles. Insurance officials' principle of care often clashed with the standardization of the process, that is based on principles of egalitarianism and equal treatment. CONCLUSIONS: The cases reported in this study suggest that a policy for activation and early return-to-work in some cases has had the opposite effect: central actors remain passive and the responsibility is placed on the sick-listed, who lacks the strength and knowledge to understand and navigate through the system. The standardized insurance system here promoted experiences of procedural injustice, for both officials and sick-listed persons.

Positive experiences of encounters with healthcare and social insurance professionals among people on long-term sick leave.

OBJECTIVE: To analyse different aspects of positive experiences of people on long-term sick leave with regard to their interactions with healthcare and social insurance professionals. METHODS: A random population-based questionnaire survey among 10,042 long-term sick-listed people in Sweden. Statements related to positive encounters with the professionals were analysed. Factor analysis and logistic regression was used to identify possible associations with gender, age, marital status, country of birth, level of education, part- or full-time sickness absence, self-rated health, depression during the past year, and reasons for sick leave. RESULTS: Ninety-two percent of respondents had experienced positive encounters with healthcare and 73% had experienced positive encounters with social insurance. The mean rating was higher for healthcare. The respondents agreed most with the items "treated me with respect", "listened to me", and "was nice to me". Three aspects of interactions were identified: competence, personal attention, and confidence and trust. Women, people born in Sweden, and individuals with good self-rated health experienced the inter-actions as most positive. CONCLUSION: The majority of the respondents on long-term sickness absence have had positive interactions with healthcare and social insurance. More research is required to determine the impact that such experiences might have on return to work, and how such interactions might be promoted.