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  • 1. Wangmar, Johanna
    et al.
    Jervaeus, Anna
    Fritzell, Kaisa
    Wångdahl, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Hultcrantz, Rolf
    Wengström, Yvonne
    Health literacy levels and views about being invited to a colorectal cancer screening program.2018In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, p. 1-7Article in journal (Refereed)
    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.

  • 2.
    Wångdahl, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Experiences of the Health Examination for Asylum Seekers - Focus Groups with Refugees in Sweden2017In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27Article in journal (Other academic)
  • 3.
    Wångdahl, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Health literacy among newly arrived refugees in Sweden and implications for health and healthcare2017Doctoral 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. 

    List of papers
    1. Health literacy among refugees in Sweden: a cross-sectional study
    Open this publication in new window or tab >>Health literacy among refugees in Sweden: a cross-sectional study
    2014 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, no 1, p. 1030-Article in journal (Refereed) Published
    Abstract [en]

    BACKGROUND: Refugees have poorer health compared to indigenous populations, which may be explained by lower health literacy, i.e. not being able to access, understand, appraise or apply health information. This study aims to determine levels of functional and comprehensive health literacy, and factors associated with inadequate health literacy, in refugees coming to Sweden.

    METHOD: A cross-sectional study was performed among 455 adult refugees speaking Arabic, Dari, Somali or English. Participants in 16 strategically selected language schools for immigrants responded to a questionnaire. Health literacy was measured using the Swedish Functional Health Literacy Scale and the HLS-EU-Q16 questionnaire. Uni- and multivariate statistical methods were used to investigate group differences.

    RESULTS: The majority of the participating refugees had inadequate or limited functional health literacy and comprehensive health literacy. About 60% of them had inadequate functional health literacy and 27% had inadequate comprehensive health literacy. Low education and/or being born in Somalia were factors associated with an increased risk of having inadequate functional health literacy. Having inadequate functional health literacy was associated with an increased risk of having inadequate comprehensive health literacy.

    CONCLUSIONS: The majority of refugees in the language schools had limited or poor health literacy. Health literacy should be taken into consideration in contexts and in activities addressing migrants. More research is needed to better understand health literacy among refugees and to develop strategies and methods to increase health literacy and make life easier for those with low health literacy.

    Keywords
    Hälsolitteracitet, migration, hälsa
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Research subject
    Social Medicine
    Identifiers
    urn:nbn:se:uu:diva-234032 (URN)10.1186/1471-2458-14-1030 (DOI)000343284400001 ()25278109 (PubMedID)
    Available from: 2014-10-13 Created: 2014-10-13 Last updated: 2017-12-05Bibliographically approved
    2. Health literacy and refugees' experiences of the health examination for asylum seekers: a Swedish cross-sectional study
    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
    2015 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, article id 1162Article in journal (Refereed) Published
    Abstract [en]

    BACKGROUND: The purpose of the health examination for asylum seekers in most countries is to identify poor health in order to secure the well-being of seekers of asylum and to guarantee the safety of the population in the host country. Functional health literacy is an individual's ability to read information and instructions about health and to function effectively as a patient in the health system, and comprehensive health literacy is an individual's competence in accessing, understanding, appraising and applying health information. Little is known about refugees' health literacy and their experiences of the health examination for asylum seekers. The purposes of the study were to investigate refugees' experiences of communication during their health examination for asylum seekers and the usefulness of that examination, and whether health literacy is associated with those experiences.

    METHODS: A cross-sectional study was made among 360 adult refugees speaking Arabic, Dari, Somali or English. Health literacy was measured using the Swedish Functional Health Literacy Scale and the short European Health Literacy Questionnaire. Experiences of communication and the usefulness of the health examination were measured in several questions. Associations were sought using univariate and multivariate statistical models.

    RESULTS: In the health examination for asylum seekers, a poor quality of communication was experienced by 36 %, receiving little information about health care by 55 %, and receiving little new knowledge by 41 % and/or help by 26 %. Having inadequate as compared to sufficient comprehensive health literacy was associated with the experience of a poorer quality of communication (OR: 9.64, CI 95 %: 3.25-28.58) and the experience of receiving little valuable health care information (OR: 6.54, CI 95 %: 2.45-17.47). Furthermore, having inadequate as compared to sufficient comprehensive health literacy was associated with the experience of not receiving new knowledge (OR: 7.94, CI 95 %: 3.00-21.06) or receiving help with health problems (OR: 8.07, 95 % CI: 2.50-26.07. Functional healthy literacy was not associated with experiences of HEA.

    CONCLUSION: Refugees' experiences indicate that a low level of comprehensive health literacy can act as a barrier to fulfilling the purposes of the health examination for asylum seekers. Comprehensive health literacy seems to be of greater importance in that context than functional health literacy.

    Keywords
    Health literacy, Refugess, Health examination, Health promotion, Sweden, S-FHL, HLS-EU-Q16
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Research subject
    Social Medicine
    Identifiers
    urn:nbn:se:uu:diva-268009 (URN)10.1186/s12889-015-2513-8 (DOI)000365311300008 ()26596793 (PubMedID)
    Funder
    Public Health Agency of Sweden
    Available from: 2015-12-01 Created: 2015-12-01 Last updated: 2017-12-01Bibliographically approved
    3. Experiences of the Health Examination for Asylum Seekers: Focus Group Discussions with Arabic and Somali Speaking Refugees in Sweden
    Open this publication in new window or tab >>Experiences of the Health Examination for Asylum Seekers: Focus Group Discussions with Arabic and Somali Speaking Refugees in Sweden
    (English)In: Article in journal (Refereed) Submitted
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Research subject
    Social Medicine; Social Medicine
    Identifiers
    urn:nbn:se:uu:diva-333396 (URN)
    Note

    This work were supported by the European Refugee Fund (ERF), under Grant number E 85-292:51-211-12792, and Foundation Olle Engkvist Byggmästare.

    Available from: 2017-11-13 Created: 2017-11-13 Last updated: 2018-02-23
    4. Poor health and refraining from seeking healthcare are associated with limited comprehensive health literacy among refugees: a Swedish cross-sectional study
    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
  • 4.
    Wångdahl, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Refugees experiences of health information in the civic orientation - Health literacy does matter2017In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27, no 3Article in journal (Other academic)
  • 5.
    Wångdahl, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Uppfattningar om arbetet med hälsoundersökningar för asylsökande: Resultat från fokusgrupper med Migrationsverks- och landstingspersonal i fyra län våren 20122014Report (Other academic)
  • 6.
    Wångdahl, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Vilken betydelse har hälsolitteracitet för hälsoundersökningen för asylsökande?2014Report (Other academic)
  • 7.
    Wångdahl, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Al Adhami, Maissa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Refugees experiences of health information in the civic orientation: Health literacy does matter2017Conference paper (Refereed)
  • 8.
    Wångdahl, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Al Adhami, Maissa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Refugees experiences of health information inthe civic orientation: Health literacy does matter2017Conference paper (Refereed)
  • 9.
    Wångdahl, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Al-Adhami, Maissa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Hälsokommunikation i samhällsorienteringen i Stockholms län 2015-2016: En utvärderingsrapport2016Report (Other academic)
  • 10.
    Wångdahl, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lau, Malena
    Kunskapscentrum för jämlik vård, Västra Götalandsregionen.
    Nordström, Pia
    Kunskapscentrum för jämlik vård, Västra Götalands regionen.
    Samulowitz, Anke
    Kunskapscentrum för jämlik vård, Västra Götalands regionen.
    Karlsson, Lovisa
    Hälsolitteracitet – en kommunikativ utmaning för hälso- och sjukvården.2017In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 94, no 2, p. 126-135Article in journal (Refereed)
    Abstract [en]

    Health literacy, the ability to obtain, understand, communicate, evaluate and use health information, is a prerequisite for patient participation. Stu-dies have shown that health literacy can affect how and when patients seek health care, participate in screening programs, follow treatment recommen-dations, and so on. Patients’ utilization of health information depend on in-dividual preconditions, but even more on health care providers’ capability to communicate and to provide inclusive and accessible information which is easy to understand. Three methods which can be used to improve health care organizations’ health literacy are: Teach-back/Förstå mig rätt, person centered patient education, and communication support with pictures. 

  • 11.
    Wångdahl, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Mårtensson, Lena
    Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden..
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Comprehensive health literacy and the experiences of the health examination for asylum seekers2015Conference paper (Refereed)
    Abstract [en]

    Objective: The purposes of the study were to investigate refugees’ experiences of communication during their health examination for asylum seekers and the usefulness of that examination, and to investigate whether health literacy is associated with those experiences.

    Methods: A cross-sectional study was performed in 2013, among 455 adult refugees speaking Arabic, Dari, Somali or English. Health literacy was measured using the Swedish Functional health literacy scale and the short European health literacy questionnaire. Experiences of communication and the usefulness of health examination for asylum seekers were measured in several questions.  Uni- and multivariate statistical methods were used to investigate group differences.

    Results: A considerable proportion of refugees in Sweden had bad experiences of the communication and the usefulness of the health examination for asylum seekers. Refugees with inadequate comprehensive health literacy experienced more communication problems and the examination as less useful, compared to those with non-inadequate comprehensive health literacy. No differences in those experiences could be seen between refugees with different levels of functional health literacy.

    Conclusion: Refugees’ own experiences indicate that a low level of comprehensive health literacy could act as a barrier to fulfilling the purposes of the health examination for asylum seekers. Comprehensive health literacy seems to be of greater importance in that context than functional health literacy

    Practical Implications: Health literacy must be highlighted and acted upon in clinical praxis to increase the quality of the health examination for asylum seekers.

  • 12.
    Wångdahl, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Mårtensson, Lena
    Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden..
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Comprehensive health literacy is associated with experiences of the health examination for asylum seekers - A Swedish cross-sectional study2016Conference paper (Refereed)
  • 13.
    Wångdahl, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Mårtensson, Lena
    Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden..
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Comprehensive health literacy is associated with experiences of the health examination for asylum seekers - A Swedish cross-sectional study2015In: The 3rd European Health Literacy Conference: Developing Health Literacy During the Life Course, 2015Conference paper (Refereed)
    Abstract [en]

    Introduction: Little is known about refugees’ health literacy (HL) and their experiences of the health examination for asylum seekers (HEA).  Communication problems and difficulties with HL are common in clinical care targeted to migrants. Limited language skills, different cultural views of health, and health care knowledge about health and health literacy may explain some of the communication problems.  From a public health perspective, communication problems are serious as they limit access to health care and information. One vulnerable group of migrants in terms of health is refugees, i.e. persons who have fled from and/or cannot return to their country for a well-founded fear of persecution, including war or civil conflict. Many refugees come into contact with health information when they participate in an HEA, provided in most countries that accept refugees.  The overall purpose of HEA is to identify poor health in order to secure the well-being of seekers of asylum and to guarantee the safety of the population in the host country.  Refugees´ experiences of communication during the HEA and about its usefulness are thus far not known. However, important information and good communication and interpersonal relations between health care receivers and providers are viewed as being important to the quality of health care.  In the context of HEA, limited HL may result in failure to identify health problems and in participants not getting treatments and information their medical situation calls for. The purposes of the study were to investigate refugees’ experiences of communication during their health examination for asylum seekers and the usefulness of that examination, and to investigate whether health literacy is associated with those experiences.

    Methods: A cross-sectional study was performed in 2013, among 455 adult refugees speaking Arabic, Dari, Somali or English. Health literacy was measured using the Swedish Functional HL Scale (S-FHL) and the short European HL Questionnaire (HLS-EU-Q16). Experiences of communication and the usefulness of HEA were measured in several questions.  Uni- and multivariate statistical methods were used to investigate group differences.

    Results: A considerable proportion of refugees in Sweden had bad experiences of the communication and the usefulness of HEA. Refugees with inadequate comprehensive HL experienced more communication problems and the examination as less useful, compared to those with non-inadequate comprehensive HL. No differences in those experiences could be seen between refugees with different levels of functional HL.

    Conclusion: Refugees’ own experiences indicate that a low level of comprehensive HL could act as a barrier to fulfilling the purposes of HEA. Comprehensive HL seems to be of greater importance in that context than functional HL. Health literacy must be highlighted and acted upon in clinical praxis to increase the quality of HEA.

  • 14.
    Wångdahl, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Mårtensson, Lena
    Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden..
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Functional and complex health literacy levels among refugees in Sweden; and examination of socio-demographic and health related factors associated with inadequate health literacy2014Conference paper (Refereed)
    Abstract [en]

    Background: Worldwide there are more than 10 million refugees; of which many have poorer health compared with indigenous populations. Not being able to access, understand, appraise or apply health information; i.e. low health literacy; could be one explanatory factor. The main purposes of this study were to determine functional and complex health literacy levels among refugees in different subgroups in Sweden; and to investigate socio-demographic and health related factors associated with inadequate health literacy.

    Method: A cross-sectional study with 455 adult refugees speaking Arabic, Dari, Somali or English; was performed. Data were collected among participants in 16 strategically selected language schools for immigrants. Health literacy was measured by translated versions of The Swedish Functional Health Literacy Scale and The HLS-EU-Q16 questionnaire. Group differences were investigated by using uni- and multivariate statistical methods.

    Results: About 60 % of the refugees had inadequate functional health literacy and about 80 % had limited functional health literacy. Regarding complex health literacy; about 27 % had inadequate complex health literacy and about 62 % had limited complex health literacy. Those having low education and/or were born in Somalia had a statistical significant increased risk of having inadequate functional health literacy. Those with inadequate functional health literacy had a statistical significant increased risk of having inadequate complex health literacy.

    Conclusions: The majority of refugees participating in the language schools had limited or poor health literacy. Compared with health literacy levels in many indigenous populations; functional as well as complex health literacy showed to be lower among the refugees in the study. Therefore health literacy should be taken into consideration in context and activities affect those. However, more research is needed for a deeper understanding of health literacy among refugees and for development of strategies and methods increasing health literacy as well as facilitating life for those with low health literacy.

  • 15.
    Wångdahl, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Mårtensson, Lena
    Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden..
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Functional and comprehensive health literacy levels among refugees in Sweden, and examination of socio-demographic and health related factors associated with inadequate health literacy2014In: / [ed] Jany Rademarkers, 2014Conference paper (Other academic)
    Abstract [en]

    Background: Worldwide there are more than 10 million refugees; of which many have poorer health compared with indigenous populations. Not being able to access, understand, appraise or apply health information; i.e. low health literacy; could be one explanatory factor. The main purposes of this study were to determine functional and complex health literacy levels among refugees in different subgroups in Sweden; and to investigate socio-demographic and health related factors associated with inadequate health literacy.

    Method: A cross-sectional study with 455 adult refugees speaking Arabic, Dari, Somali or English; was performed. Data were collected among participants in 16 strategically selected language schools for immigrants. Health literacy was measured by translated versions of The Swedish Functional Health Literacy Scale and The HLS-EU-Q16 questionnaire. Group differences were investigated by using uni- and multivariate statistical methods.

    Results: About 60 % of the refugees had inadequate functional health literacy and about 80 % had limited functional health literacy. Regarding complex health literacy; about 27 % had inadequate complex health literacy and about 62 % had limited complex health literacy. Those having low education and/or were born in Somalia had a statistical significant increased risk of having inadequate functional health literacy. Those with inadequate functional health literacy had a statistical significant increased risk of having inadequate complex health literacy.

    Conclusions: The majority of refugees participating in the language schools had limited or poor health literacy. Compared with health literacy levels in many indigenous populations; functional as well as complex health literacy showed to be lower among the refugees in the study. Therefore health literacy should be taken into consideration in context and activities affect those. However, more research is needed for a deeper understanding of health literacy among refugees and for development of strategies and methods increasing health literacy as well as facilitating life for those with low health literacy.

  • 16.
    Wångdahl, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Mårtensson, Lena
    Göteborgs Universitet.
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Health literacy among refugees in Sweden: a cross-sectional study2014In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, no 1, p. 1030-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Refugees have poorer health compared to indigenous populations, which may be explained by lower health literacy, i.e. not being able to access, understand, appraise or apply health information. This study aims to determine levels of functional and comprehensive health literacy, and factors associated with inadequate health literacy, in refugees coming to Sweden.

    METHOD: A cross-sectional study was performed among 455 adult refugees speaking Arabic, Dari, Somali or English. Participants in 16 strategically selected language schools for immigrants responded to a questionnaire. Health literacy was measured using the Swedish Functional Health Literacy Scale and the HLS-EU-Q16 questionnaire. Uni- and multivariate statistical methods were used to investigate group differences.

    RESULTS: The majority of the participating refugees had inadequate or limited functional health literacy and comprehensive health literacy. About 60% of them had inadequate functional health literacy and 27% had inadequate comprehensive health literacy. Low education and/or being born in Somalia were factors associated with an increased risk of having inadequate functional health literacy. Having inadequate functional health literacy was associated with an increased risk of having inadequate comprehensive health literacy.

    CONCLUSIONS: The majority of refugees in the language schools had limited or poor health literacy. Health literacy should be taken into consideration in contexts and in activities addressing migrants. More research is needed to better understand health literacy among refugees and to develop strategies and methods to increase health literacy and make life easier for those with low health literacy.

  • 17.
    Wångdahl, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Mårtensson, Lena
    Göteborgs universitet.
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Health literacy and refugees' experiences of the health examination for asylum seekers: a Swedish cross-sectional study2015In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, article id 1162Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The purpose of the health examination for asylum seekers in most countries is to identify poor health in order to secure the well-being of seekers of asylum and to guarantee the safety of the population in the host country. Functional health literacy is an individual's ability to read information and instructions about health and to function effectively as a patient in the health system, and comprehensive health literacy is an individual's competence in accessing, understanding, appraising and applying health information. Little is known about refugees' health literacy and their experiences of the health examination for asylum seekers. The purposes of the study were to investigate refugees' experiences of communication during their health examination for asylum seekers and the usefulness of that examination, and whether health literacy is associated with those experiences.

    METHODS: A cross-sectional study was made among 360 adult refugees speaking Arabic, Dari, Somali or English. Health literacy was measured using the Swedish Functional Health Literacy Scale and the short European Health Literacy Questionnaire. Experiences of communication and the usefulness of the health examination were measured in several questions. Associations were sought using univariate and multivariate statistical models.

    RESULTS: In the health examination for asylum seekers, a poor quality of communication was experienced by 36 %, receiving little information about health care by 55 %, and receiving little new knowledge by 41 % and/or help by 26 %. Having inadequate as compared to sufficient comprehensive health literacy was associated with the experience of a poorer quality of communication (OR: 9.64, CI 95 %: 3.25-28.58) and the experience of receiving little valuable health care information (OR: 6.54, CI 95 %: 2.45-17.47). Furthermore, having inadequate as compared to sufficient comprehensive health literacy was associated with the experience of not receiving new knowledge (OR: 7.94, CI 95 %: 3.00-21.06) or receiving help with health problems (OR: 8.07, 95 % CI: 2.50-26.07. Functional healthy literacy was not associated with experiences of HEA.

    CONCLUSION: Refugees' experiences indicate that a low level of comprehensive health literacy can act as a barrier to fulfilling the purposes of the health examination for asylum seekers. Comprehensive health literacy seems to be of greater importance in that context than functional health literacy.

  • 18.
    Wångdahl, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Mårtensson, Lena
    Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden..
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Health literacy and refugees’ experiences of the health examination for asylum seekers: a Swedish cross-sectional study2017Conference paper (Refereed)
  • 19.
    Wångdahl, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Mårtensson, Lena
    Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden..
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Health literacy and refugees’ experiences of the health examination for asylum seekers: a Swedish cross-sectional study2017Conference paper (Refereed)
  • 20.
    Wångdahl, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Mårtensson, Lena
    Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden..
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Poor health and refraining from seeking healthcare are associated with limited comprehensive health literacy among refugees: a Swedish cross-sectional study2018In: International Journal of Public Health, ISSN 1661-8556, E-ISSN 1661-8564, Vol. 63, no 3, p. 409-419Article in journal (Refereed)
    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.

  • 21.
    Wångdahl, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Mårtensson, Lena
    Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden..
    Wetserling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Functional and comprehensive health literacy levels among refugees in Sweden, and examination of socio-demographic and health related factors associated with inadequate health literacy2014Conference paper (Refereed)
    Abstract [en]

    Background: Worldwide there are more than 10 million refugees; of which many have poorer health compared with indigenous populations. Not being able to access, understand, appraise or apply health information; i.e. low health literacy; could be one explanatory factor. The main purposes of this study were to determine functional and complex health literacy levels among refugees in different subgroups in Sweden; and to investigate socio-demographic and health related factors associated with inadequate health literacy.

    Method: A cross-sectional study with 455 adult refugees speaking Arabic, Dari, Somali or English; was performed. Data were collected among participants in 16 strategically selected language schools for immigrants. Health literacy was measured by translated versions of The Swedish Functional Health Literacy Scale and The HLS-EU-Q16 questionnaire. Group differences were investigated by using uni- and multivariate statistical methods.

    Results: About 60 % of the refugees had inadequate functional health literacy and about 80 % had limited functional health literacy. Regarding complex health literacy; about 27 % had inadequate complex health literacy and about 62 % had limited complex health literacy. Those having low education and/or were born in Somalia had a statistical significant increased risk of having inadequate functional health literacy. Those with inadequate functional health literacy had a statistical significant increased risk of having inadequate complex health literacy.

    Conclusions: The majority of refugees participating in the language schools had limited or poor health literacy. Compared with health literacy levels in many indigenous populations; functional as well as complex health literacy showed to be lower among the refugees in the study. Therefore health literacy should be taken into consideration in context and activities affect those. However, more research is needed for a deeper understanding of health literacy among refugees and for development of strategies and methods increasing health literacy as well as facilitating life for those with low health literacy.

  • 22.
    Wångdahl, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Mårtensson, Lena
    Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden..
    Experiences of the Health Examination for Asylum Seeker: Focus Group Discussions with Arabic and Somali Speaking Refugees in Sweden2017Conference paper (Refereed)
  • 23.
    Wångdahl, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Mårtensson, Lena
    Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden..
    Experiences of the Health Examination for Asylum Seeker: Focus Group Discussions with Arabic and Somali Speaking Refugees in Sweden2017Conference paper (Refereed)
  • 24.
    Wångdahl, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Mårtensson, Lena
    Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden..
    Experiences of the Health Examination for Asylum Seeker: Focus Group Discussions with Arabic and Somali Speaking Refugees in Sweden2017Conference paper (Refereed)
  • 25.
    Wångdahl, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Mårtensson, Lena
    Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden..
    Experiences of the HealthExamination for Asylum Seeker: Focus Group Discussions with Arabic and Somali Speaking Refugees in Sweden2017Conference paper (Refereed)
  • 26.
    Wångdahl, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Mårtensson, Lena
    Göteborgs Universitet.
    Measuring health literacy: the Swedish Functional Health Literacy scale2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 1, p. 165-172Article in journal (Refereed)
    Abstract [en]

    Background:

    The benefits of health promotions efforts vary due to a complexity of reasons. One possible reason for absence of effects is the level of functional health literacy among the individuals that participate in the interventions. Thus valid and reliable instruments that capture these kinds of skills are needed. The aim of this study was to develop a Swedish Functional Health Literacy scale to use in health promotion and health prevention by translating the Japanese Functional Health Literacy scale into Swedish and testing some aspects of its validity and test-retest reliability.

    Methods: The research project comprised six phases including translation and back-translation, validity tests on the two first versions of the instrument based on interviews of professionals and representatives for the target group of the instrument, and a test-retest of the first version on target groups.  

    Results: The items in the first two versions were experienced as unclear, which led to improvements of the next version.  The final version of the translated instrument (The Swedish Functional Literacy scale) showed evidence of content validity and the test- retest confirmed that instrument had stability over time with a percentage agreements for the items ranging from 63% to 92% (M = 77,2%).  

    Conclusion: The items in the Swedish version of the scale is equivalent to the original Japanese scale in terms of language and content and covers the major aspects of functional health literacy as it is defined in the literature. The translated instrument shows stability over time, i.e. reliability, at least for a part of the Swedish population. More validity tests of the Swedish Functional Health Literacy scale based on a broader population are needed.

  • 27.
    Wångdahl, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Mårtensson, Lena
    Göteborgs universitet.
    The Communicative and Critical Health Literacy Scale: Swedish Version2014In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, no 1, p. 25-31Article in journal (Refereed)
    Abstract [en]

    Health literacy (HL) is an important determinant for health and a valuable health indicator within public health. As such, it is a significant outcome variable of health promotion efforts. Valid and reliable instruments are needed to evaluate health promotion interventions and to assess levels of HL in a population. One of the few measurements of communicative and critical HL is the Japanese Communicative and Critical Health Literacy scale (C & C HL scale). To make it possible to use this instrument in Sweden, the C & C HL scale was translated into Swedish and different aspects of validity, including test–retest reliability, of the translated version were tested. Methods: After translation and back-translation, The Swedish C & C HL scale was tested for content validity and test–retest reliability. Data were collected from a committee consisting of public health experts and bilingual people, and from a test group of 35 persons. Results: The Swedish C & C HL scale was understandable and showed evidence of content validity. The test–retest confirmed that it was stable over time, percentage agreements for the items ranging from 66% to 89% (M = 74%).

    Conclusions: The Swedish C & C HL scale is equivalent to the Japanese C & C HL scale in terms of language and content. The items cover the major aspects of communicative and critical HL and are understandable and stable over time, i.e., reliable.

  • 28.
    Wångdahl, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Westerling, Ragnar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Mårtensson, Lena
    Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden..
    Experiences of the Health Examination for Asylum Seekers: Focus Group Discussions with Arabic and Somali Speaking Refugees in SwedenIn: Article in journal (Refereed)
  • 29.
    Wångdahl, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Åhs, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Social Medicine.
    Projekt Athena: En användbar metod för att främja närhet till arbetsmarknaden och hälsa hos långtidsarbetslösa utlandsfödda kvinnor?2014Report (Other academic)
1 - 29 of 29
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