title: Understanding the "black box" of a health-promotion program: Keys to enable health among older persons aging in the context of migration.
abstract: 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 implemented in an adapted version of a group-based HPP developed in a researcher-community partnership. Fourteen persons aged 70-83 years or older who had migrated to Sweden from Finland or the Balkan Peninsula were included. A grounded theory approach guided the data collection and analysis. The findings showed 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 are being shaped by the group, the key processes could both inhibit or encourage opening doors to awareness. Therefore, this study provides key insights into how to enable health by deepening the understanding of how the exchange of health-promoting messages is experienced to be facilitated or hindered. This study 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.
authors.affiliation: Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.|Department of Occupational Therapy and Physiotherapy, The Sahlgrenska University Hospital, Gothenburg, Sweden.|Centre for Ageing and Health - AgeCap, University of Gothenburg, Gothenburg, Sweden; emmelie.barenfeld@neuro.gu.se.
authors.forename: Emmelie
authors.initials: E
authors.lastname: Barenfeld
authors.affiliation: Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.|Centre for Ageing and Health - AgeCap, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Susanne
authors.initials: S
authors.lastname: Gustafsson
authors.affiliation: School of Education, Health, and Social Studies, Dalarna University, Falun, Sweden.|Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Wallin
authors.affiliation: Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.|Centre for Ageing and Health - AgeCap, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Synneve
authors.initials: S
authors.lastname: Dahlin-Ivanoff
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001364:Awareness; D063368:Balkan Peninsula / Q000208:ethnology; D003142:Communication; D003256:Community Participation; D032882:Comprehension; D054242:Emigrants and Immigrants; D004641:Emigration and Immigration; D005260:Female; D005387:Finland / Q000208:ethnology; D006282:Health Personnel; D006293:Health Promotion; D006299:Health Services for the Aged; D006801:Humans; D019359:Knowledge; D008297:Male; D017060:Patient Satisfaction; D028723:Personhood; D015397:Program Evaluation; D012111:Residence Characteristics; D013548:Sweden
keywords: Immigrant; emigrant; grounded theory; group intervention; health-promoting messages; occupation; person-centeredness