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Wangmar, J., Jervaeus, A., Fritzell, K., Wångdahl, J., Hultcrantz, R. & Wengström, Y. (2018). Health literacy levels and views about being invited to a colorectal cancer screening program.. Acta Oncologica, 1-7
Open this publication in new window or tab >>Health literacy levels and views about being invited to a colorectal cancer screening program.
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2018 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, p. 1-7Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Sweden has not yet implemented a national screening program for colorectal cancer, but a nationwide study is ongoing; the Screening of Swedish Colons (SCREESCO). Previous research shows that the use of health care services, together with several health-related outcomes, is associated with an individual's level of health literacy. However, the relation between health literacy and participation in colorectal cancer screening has produced varying results reported within the few studies addressing this issue and therefore, further research is warranted.

MATERIAL AND METHODS: The aim was to explore health literacy and views about being invited to screening, among participants and non-participants in a national colorectal cancer screening program. They were randomly sampled to fecal immunochemical test or colonoscopy and a mixed methods approach was applied, using questionnaires, focus group discussions and interviews.

RESULTS: The majority of individuals, whether they were participants or non-participants in the SCREESCO program, had an acceptable level of health literacy and no significant differences in health literacy levels between the groups were found. Participants expressed that it was important and appreciated to be able to choose information sources on an individual basis. Among non-participants, the importance of receiving invitations with a clear message that quickly draws one's attention was highlighted. However, both groups expressed a positive outlook towards the invitation. The mixed methods approach revealed that findings from interviews and focus group discussions corresponded to items in the health literacy scales.

CONCLUSION: A majority of individuals displayed acceptable levels of health literacy, regardless of whether they chose to participate or not. Similarities between the groups were seen in the qualitative findings regarding views of the invitation. Currently, the SCREESCO invitation letter is distributed by regular mail, but in the future a more dynamic approach could be valuable to increase clarity in the message about importance of screening.

National Category
Cancer and Oncology Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Social Medicine; Oncology
Identifiers
urn:nbn:se:uu:diva-339685 (URN)10.1080/0284186X.2017.1420911 (DOI)29308944 (PubMedID)
Available from: 2018-01-22 Created: 2018-01-22 Last updated: 2018-02-23
Wångdahl, J., Lytsy, P., Mårtensson, L. & Westerling, R. (2018). Poor health and refraining from seeking healthcare are associated with limited comprehensive health literacy among refugees: a Swedish cross-sectional study. International Journal of Public Health, 63(3), 409-419
Open this publication in new window or tab >>Poor health and refraining from seeking healthcare are associated with limited comprehensive health literacy among refugees: a Swedish cross-sectional study
2018 (English)In: International Journal of Public Health, ISSN 1661-8556, E-ISSN 1661-8564, Vol. 63, no 3, p. 409-419Article in journal (Refereed) Published
Abstract [en]

Objectives: The objectives of the study were to explore the distributions of comprehensive health literacy (CHL), general health, psychological well-being and having refrained from seeking healthcare among refugees in Sweden. Further objectives were to examine associations between CHL and the above mentioned factors.

Methods: A cross-sectional study was conducted among 513 refugees speaking Arabic, Dari and Somali. Participants in the civic orientation course in Sweden responded to a questionnaire. CHL was measured using the HLS-EU-Q16 questionnaire. Uni- and multivariate logistic regression was used to investigate potential associations.

Results: The majority of the respondents had limited CHL, and about four of ten had reported poor health and/or having refrained from seeking healthcare. Limited CHL was associated with having reported poor health and having refrained from seeking healthcare. 

Conclusions: A considerable proportion of the refugees in Sweden have limited CHL, and report less than good health and impaired well-being, or that they have refrained from seeking healthcare. Further, CHL is associated with the above mentioned factors. Efforts are needed to promote refugees' CHL, optimal health seeking behavior, and health.

Keywords
health literacy, general health, psychological well-being, refrained from healthcare, refugees
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Social Medicine
Identifiers
urn:nbn:se:uu:diva-333397 (URN)10.1007/s00038-017-1074-2 (DOI)000428236500012 ()29480325 (PubMedID)
Note

The study was co-financed by the County Administrative Board in Stockholm.

Available from: 2017-11-13 Created: 2017-11-13 Last updated: 2018-06-20Bibliographically approved
Wångdahl, J., Lytsy, P., Westerling, R. & Mårtensson, L. (2017). Experiences of the Health Examination for Asylum Seeker: Focus Group Discussions with Arabic and Somali Speaking Refugees in Sweden. In: : . Paper presented at U4 Cluster Conference Social Sciences, Economics and Law (SSEL), Uppsala, 29-30 May, 2017.
Open this publication in new window or tab >>Experiences of the Health Examination for Asylum Seeker: Focus Group Discussions with Arabic and Somali Speaking Refugees in Sweden
2017 (English)Conference paper, Oral presentation only (Refereed)
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Health Care Research
Identifiers
urn:nbn:se:uu:diva-342969 (URN)
Conference
U4 Cluster Conference Social Sciences, Economics and Law (SSEL), Uppsala, 29-30 May, 2017
Available from: 2018-02-23 Created: 2018-02-23 Last updated: 2018-02-23
Wångdahl, J., Lytsy, P., Westerling, R. & Mårtensson, L. (2017). Experiences of the Health Examination for Asylum Seeker: Focus Group Discussions with Arabic and Somali Speaking Refugees in Sweden. In: : . Paper presented at International Conference on Communication in Healthcare & Health Literacy Annual Research Conference (ICCH/HAARC) 2017.
Open this publication in new window or tab >>Experiences of the Health Examination for Asylum Seeker: Focus Group Discussions with Arabic and Somali Speaking Refugees in Sweden
2017 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Social Medicine
Identifiers
urn:nbn:se:uu:diva-333778 (URN)
Conference
International Conference on Communication in Healthcare & Health Literacy Annual Research Conference (ICCH/HAARC) 2017
Available from: 2017-11-16 Created: 2017-11-16 Last updated: 2018-02-23
Wångdahl, J., Lytsy, P., Westerling, R. & Mårtensson, L. (2017). Experiences of the Health Examination for Asylum Seeker: Focus Group Discussions with Arabic and Somali Speaking Refugees in Sweden. In: : . Paper presented at U4 Cluster Conference Social Sciences, Economics and Law (SSEL), 29-30 May, 2017.
Open this publication in new window or tab >>Experiences of the Health Examination for Asylum Seeker: Focus Group Discussions with Arabic and Somali Speaking Refugees in Sweden
2017 (English)Conference paper, Oral presentation only (Refereed)
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Social Medicine
Identifiers
urn:nbn:se:uu:diva-333772 (URN)
Conference
U4 Cluster Conference Social Sciences, Economics and Law (SSEL), 29-30 May, 2017
Available from: 2017-11-16 Created: 2017-11-16 Last updated: 2018-02-23
Wångdahl, J. (2017). Experiences of the Health Examination for Asylum Seekers - Focus Groups with Refugees in Sweden. European Journal of Public Health, 27
Open this publication in new window or tab >>Experiences of the Health Examination for Asylum Seekers - Focus Groups with Refugees in Sweden
2017 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27Article in journal, Meeting abstract (Other academic) Published
National Category
Health Sciences
Identifiers
urn:nbn:se:uu:diva-345686 (URN)000414389805124 ()
Available from: 2018-03-16 Created: 2018-03-16 Last updated: 2018-03-16Bibliographically approved
Wångdahl, J., Lytsy, P., Westerling, R. & Mårtensson, L. (2017). Experiences of the HealthExamination for Asylum Seeker: Focus Group Discussions with Arabic and Somali Speaking Refugees in Sweden. In: : . Paper presented at 10th European Public Health Conference - Stockholm 2017.
Open this publication in new window or tab >>Experiences of the HealthExamination for Asylum Seeker: Focus Group Discussions with Arabic and Somali Speaking Refugees in Sweden
2017 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Social Medicine
Identifiers
urn:nbn:se:uu:diva-333779 (URN)
Conference
10th European Public Health Conference - Stockholm 2017
Available from: 2017-11-16 Created: 2017-11-16 Last updated: 2018-02-23
Wångdahl, J. (2017). Health literacy among newly arrived refugees in Sweden and implications for health and healthcare. (Doctoral dissertation). Uppsala: Acta Universitatis Upsaliensis
Open this publication in new window or tab >>Health literacy among newly arrived refugees in Sweden and implications for health and healthcare
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to examine the distribution of health literacy (HL) levels in newly arrived Arabic-, Dari-, or Somali-speaking refugees in Sweden. Further aims were to investigate sociodemographic characteristics associated with inadequate HL in this group, and to investigate whether HL levels are associated with experiences of the health examination for asylum seekers (HEA), health seeking behaviour and health.

Three quantitative cross-sectional studies, using data from two different surveys, were conducted among Arabic-, Dari-, and Somali-speaking, newly arrived refugees taking part in courses in Swedish for immigrants or civic orientation. In addition, an explorative qualitative study, based on focus group discussions, was performed on Arabic- and Somali-speaking newly arrived refugees who had taken part in an HEA. All data were collected 2013-2016. The quantitative data were analysed using different statistical methods, foremost descriptive statistics and univariate and multivariate binary logistic regression analyses. The qualitative data were analysed using Graneheim and Lundman’s method for latent content analysis.

The main findings were that the majority of Arabic-, Dari-, or Somali-speaking refugees in Sweden have limited functional health literacy (FHL) and/or limited comprehensive health literacy (CHL). Having a low education level and/or being born in Somalia were associated with having inadequate FHL, but not with having inadequate CHL. Limited FHL was associated with inadequate CHL. Experiences of poor quality of communication and having benefited little from the HEA were more common among those with limited CHL, as compared to those with higher CHL. Experiences of communication problems and a lack of information related to the HEA were found in the qualitative studies as well. In addition, it was more common that those with limited CHL reported poor general health and impaired psychological well-being, and that they had refrained from seeking healthcare.

In conclusion: limited HL is common among newly arrived refugees in Sweden and seems to be of importance for the experience of the HEA, health-seeking behaviour and health. HL needs to be taken into consideration in the work with refugees in order to increase equity in healthcare and health. 

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2017. p. 102
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1397
Keywords
Health literacy, S-FHL, HLS-EU-Q16, Asylum seeker, Migrant, Immigrant, Experiences, Health check-up, Communication, Information, Self-perceived health, Mental health, Health-seeking behaviour, Refrained from healthcare, Screening, Disease prevention, Health promotion, Quality of care, Equity in health
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Social Medicine
Identifiers
urn:nbn:se:uu:diva-333427 (URN)978-91-513-0159-4 (ISBN)
Public defence
2018-01-10, Polhemssalen, Ångströmlaboratoriet, Lägerhyddsvägen 1, Uppsala, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2017-12-20 Created: 2017-11-20 Last updated: 2018-03-08
Wångdahl, J., Lytsy, P., Mårtensson, L. & Westerling, R. (2017). Health literacy and refugees’ experiences of the health examination for asylum seekers: a Swedish cross-sectional study. In: : . Paper presented at International Conference on Communication in Healthcare & Health Literacy Annual Research Conference (ICCH/HAARC) 2017.
Open this publication in new window or tab >>Health literacy and refugees’ experiences of the health examination for asylum seekers: a Swedish cross-sectional study
2017 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Social Medicine
Identifiers
urn:nbn:se:uu:diva-333773 (URN)
Conference
International Conference on Communication in Healthcare & Health Literacy Annual Research Conference (ICCH/HAARC) 2017
Available from: 2017-11-16 Created: 2017-11-16 Last updated: 2018-02-23
Wångdahl, J., Lytsy, P., Mårtensson, L. & Westerling, R. (2017). Health literacy and refugees’ experiences of the health examination for asylum seekers: a Swedish cross-sectional study. In: : . Paper presented at U4 Cluster Conference Social Sciences, Economics and Law (SSEL), Uppsala, 29-30 May, 2017.
Open this publication in new window or tab >>Health literacy and refugees’ experiences of the health examination for asylum seekers: a Swedish cross-sectional study
2017 (English)Conference paper, Oral presentation only (Refereed)
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Social Medicine
Identifiers
urn:nbn:se:uu:diva-333770 (URN)
Conference
U4 Cluster Conference Social Sciences, Economics and Law (SSEL), Uppsala, 29-30 May, 2017
Available from: 2017-11-16 Created: 2017-11-16 Last updated: 2018-02-23
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-4743-8259

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