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Understanding the “black box” of a health-promotion program: Keys to enable health among older persons aging in the context of migration

Journal article
Authors Emmelie Barenfeld
Susanne Gustafsson
Lars Wallin
Synneve Dahlin-Ivanoff
Published in International Journal of Qualitative Studies on Health and Well-being
Volume 10
Pages 29013
ISSN 1748-2623
Publication year 2015
Published at Institute of Neuroscience and Physiology, Department of Health and Rehabilitation
Centre for Ageing and Health (Agecap)
Pages 29013
Language en
Keywords Immigrant, emigrant, occupation, group intervention, person-centeredness, grounded theory, health promoting messages
Subject categories Occupational Therapy, Gerontology, specializing in Medical and Health Sciences


Although the need to make health services more accessible to persons who have migrated has been identified, knowledge about health-promotion programs (HPPs) from the perspective of older persons born abroad is lacking. This study explores the design experiences and content of an adapted version of a group-based HPP developed in a researcher–community partnership. Fourteen persons aged 70 years or older who migrated to Sweden from Finland or the Balkan Peninsula were included. A grounded theory approach guided the data collection and analysis. The findings visualized how participants and personnel jointly helped raise awareness. The participants experienced three key processes that could open doors to awareness: enabling community, providing opportunities to understand and be understood; and confirming human values and abilities. Depending on how the HPP content and design is being shaped by the group, the key processes could both inhibit and encourage opening doors to awareness. Therefore, this study provided key insights into how to enable health by deepening the understanding of facilitators and revealing barriers in exchanging the health-promoting messages valued by the participants. This adds to the scientific knowledge base of how the design and content of HPP may support and recognize the capabilities of persons aging in the context of migration.

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