This study analyzes a community-based crisis response to the COVID-19 pandemic in a socioeconomically deprived area in Malmö, Sweden, where a gap regarding accessible information was perceived. It aims at furthering the understanding of how social capital may facilitate collective action, thereby contributing to the understanding of community resilience in the face of risks, uncertainty, and hardships. An ethnographic method based on observations and focus groups interviews was employed. By applying Dynes' elaboration of Coleman's outline of social capital, in a crisis context, as well as assuming bonding, bridging, and linking social capital as available mechanisms for mobilizing collective resources across a socially layered context, the study confirmed a capacity to respond in a timely way – a response facilitated by collective assets embedded in relationships and networks, that is, social capital. The result confirms the significance of having a pre-crisis capacity to meet existing needs effectively, and of having a normative basis of reciprocity that ensures an inclusive response, founded on an emergency consensus. This speaks for a complementary bottom-up model for a community-based crisis planning approach and has implications for the supportive roles that both public and civil sectors can play in recognizing the importance of social capital in building resilience. Support provided to local communities can enable them to develop emergent organizations countering social inequalities in disasters, and it could, if integrated into the contingency system, translate into more inclusive responses to future crises.

Background: The COVID-19 pandemic had a significant impact on the public health and the economy of the Swedish population, with disproportionate effects on communities living in socioeconomically diverse neighborhoods. To mitigate these impacts and enhance outreach, COVID-19 diagnostic and prevention services supported by digital health tools were introduced for early diagnosis and prevention. Assessing the perceptions related to utilization of these efforts is essential to ensure they are benefiting the particular populations living in socioeconomically disadvantaged neighborhoods. Therefore, the aim of this study was to demonstrate available COVID-19 diagnostic tools and explore the implementation of COVID-19 diagnostics and the digital support services from the experiences of lay health promoters (LHPs) in a socioeconomically disadvantaged neighborhood in Malmö. Method: Five LHPs participated in an online focus group via Zoom, in May 2021. The session began with an online presentation of testing procedures, followed by discussion to gather user perspectives. The data was analyzed using the Rapid Identification of Themes from Audio recordings method. Results: Health promoters reported a lack of trust in existing COVID self-test procedures due to validity issues and frequent false-negative results. Polymerase chain reaction testing procedures were deemed inadequate because of delays in receiving results. Additionally, the neighborhood faced barriers to vaccination access, including challenges in using digital technology to book test and vaccination, distance to vaccination centers, and unavailability of slots. Conclusion: This study highlights the need for affordable and easy-to-use COVID-19 test alternatives in these neighborhoods. The implementation of digital healthcare solutions during the pandemic faced significant challenges, limiting access to care and support in socioeconomically disadvantaged neighborhoods. Therefore, implementing digital healthcare initiatives for disease diagnosis and prevention at the national level requires strategic planning that considers the needs and capabilities of residents in socioeconomically disadvantaged areas. Furthermore, the importance of increasing targeted vaccination centers and educating community representatives, such as health promoters, to better support their communities during crises, was emphasized.

AIMS AND OBJECTIVES: To describe first-line managers' (FLMs) views of the challenges faced by staff when encountering older people's existential concerns in home and residential care.

METHODOLOGICAL DESIGN AND JUSTIFICATION: This cross-sectional study uses a combination of qualitative and quantitative methods.

ETHICAL ISSUES AND APPROVAL: The study was approved by the Swedish Ethical Review Authority (ref. number 2014/652 ) and followed the guidelines of the Helsinki Declaration.

RESEARCH METHODS: FLMs in home and residential care were randomly selected and invited to participate. A self-administered questionnaire was distributed online to 467 managers, 136 (29%) of whom completed it.

RESULTS: About 80% of the FLMs reported that their staff members sometimes or frequently had conversations with the older people in their care about existential concerns, including the following topics: thoughts and feelings about meaning in life; losses and longing for meaningful relations; death, fears and uncertainty and supporting meaningful everyday life. About 75% of the managers also reported that their staff sometimes or often had conversations about existential concerns with one another. Major hindrances to existential conversations were reportedly cognitive impairment and aphasia among the older people and insecurity and unwillingness among the staff. Most managers (73%) reported that their staff received support when encountering existential concerns, mostly as individual support from managers or registered nurses.

STUDY LIMITATIONS: The main limitation of this study is its low response rate, which is common for digital surveys. Nevertheless, the sample is considered to be representative; therefore, the study holds exploratory value.

CONCLUSION: Regular conversations among staff, improved conversational skills and the ability to listen reflect on and perceive older people's perspective and life world are needed when encountering older people's existential concerns. FLMs play a crucial role in emphasising and planning staff support on a regular basis.

Purpose: Medication non-adherence is a global public health issue influenced by various factors, including the quality and comprehensiveness of medication information provided to patients. Migrants, particularly women, face unique healthcare and societal challenges in their new home countries. This study aims to explore Arabic-speaking migrant women’s experiences and perspectives on medication information and use.

Methods: This study was part of the Equal Health program, a health promotion initiative established in socially vulnerable areas to address health inequities. Arabic-speaking women aged 40–80 years with chronic illnesses participated in multistage focus group sessions exploring their experiences with medication information from healthcare, medication use, and perspectives on necessary improvements in medication information at hospital discharge. The sessions were conducted in Arabic, audio-recorded, transcribed verbatim, and translated into Swedish for analysis. Data were analyzed using Braun and Clark’s six-phase reflexive thematic analysis.

Results: Four multistage focus group sessions with 15 participants were conducted. The analysis generated three themes: receiving or not receiving professional medication information, medication adherence patterns, and needs and suggestions for improved medication information—a call for action. Participants reported inadequate medication information from physicians, particularly at the time of discharge from the hospital, and described instances of intentional and unintentional non-adherence. Suggestions for improvement included providing written medication information at discharge in their native language, using interpreters, and including a current medication list detailing overall medication information and potential drug interactions.

Conclusion: This study highlights inadequate medication information provision to Arabic-speaking migrant women, which may impact medication use and pose patient safety risks. Although the adherence patterns of the study subjects resembled those of the general population, unique barriers require additional healthcare support. This study can inform healthcare practices and establish a foundation for further research on medication information and use in this group, including comparisons with native-born individuals.

Background: Children with migration background, living in socio-economically disadvantaged areas, are exposed to numerous risk that can negatively affect their well-being. Understanding which key factors build and enable well-being of children with these experiences are therefore essential to support and strengthen their positive development and possibilities to feel well. Studies that include children’s own perspectives and voices in initiatives that concerns them is however scarce, and there is an increased need for participation of children with diverse experiences and life situations in research and knowledge production. Therefore, the aim of this study was to, through a participatory process, explore and enhance the understanding of key factors in the social context that contribute to child well-being among children with a migration background.

Methods: Thirty-one children, aged 9–12, from three disadvantaged areas in Malmö, Sweden, participated together with researchers in a Community-Based Participatory Research (CBPR) team, exploring factors related to their well-being in their social context. Multi-stage focus groups were held over a year (2023–2024), with different sessions facilitating dialog on the research topic. In total, 49 sessions took place, each on average duration of 1.5 h. The data were analyzed using inductive thematic analysis.

Results: Four main themes, representing key factors related to child well-being, were identified: Enriching Leisure Time, Resourceful Places, Belonging to a Community and Welfare System and Rights. The themes covered structural aspects, such as school, healthcare and human rights, but also more personal dimensions, like close relations and the near environment, related to Bronfenbrenner’s ecological theory of human development.

Conclusion: The dialogs with the children provided a deeper understanding and a holistic view of the perceptions of children with migration backgrounds residing in socio-economically disadvantaged areas regarding essential factors for their well-being. Future research should focus on developing strategies that ensure children’s access to the factors they have identified as fundamental to their well-being. Our study has further shown that it is pivotal to ensure children’s inclusion and participation in health promotion initiatives. These initiatives need to be contextually relevant and work toward building community capacity, to promote child well-being.

Aim: To identify existing public knowledge regarding diabetes and diabetes-related services offered to persons living with diabetes in the City of Malmö.

Methods: A literature review of City of Malmö’s website, public statistics, School health documentation, job databases, education programs, local newspaper, Swedish National Diabetes Register, and PubMed was performed in 2020.

Results: We identified political decisions about diabetes nurses in home care, financing a project about diabetes complications, and funding support in schools for designated children. Schools had no registrations of diagnoses. Diabetes was common among pregnant women. The local newspaper discussed children and older people with diabetes asking for increased support. Job listings did not require diabetes-relevant competencies. Curricula for nursing assistants did not mention diabetes. National Diabetes Register reported 16,658 persons in Malmö. Three articles were identified in PubMed.

Conclusion: Public documents in Malmö did not mention diabetes despite being responsible for caring for persons with diabetes.

Existential loneliness is a profound sense of loneliness that arises when confronting existential questions, often intensified by the awareness of mortality. For older migrants, this experience may be deepened by feelings of exclusion and a disrupted sense of belonging. While existential loneliness has been explored in general older populations, little is known about how it is perceived and addressed by healthcare support staff working with older migrants. This study explores healthcare support staff’s perceptions of existential loneliness among older migrants and the conditions necessary to address their needs. Using focus group methodology, analysis of data generated the overarching theme of “Navigating the unseen,” capturing the complexity of recognizing and responding to existential loneliness. Three subthemes illustrate how HSSs perceive and respond to experiences of EL among older migrants. The first two—(a) “Feelings of exclusion contribute to the experience of EL” and (b) “The ongoing quest for belonging”—highlight how participants perceived older migrants’ experiences of EL. The third subtheme, “Aspects influencing HSSs’ engagement with older migrants experiencing EL,” captures factors that shape HSSs’ capacity to support this population. This study highlights the complex challenges staff face in addressing existential loneliness in this population. To meet these needs, staff require time, training, and managerial support. Building trustful relationships, fostering cultural and religious inclusivity, and integrating psychosocial care are essential to support older migrants in finding meaning and belonging in later life

Introduction: The prevalence of type 2 diabetes has increased worldwide, where the highest prevalence has been found in the Eastern Mediterranean region. Effective measures must be taken to prevent or delay the occurrence of type 2 diabetes and its complications. The present study aimed to investigate the correlation between factors linked to risk for diabetes, individually and cumulatively, and established diabetes in recently arrived migrants from Iraq and Syria in Scania and compare it to the rest of the population.

Method: A cross-sectional survey was used to compare data between a sample of recently arrived migrants and a sample from the rest of the population in Scania, Sweden.

Results: The prevalence of self-reported diabetes was significantly higher among recently arrived migrants (6.9%) compared to the rest of the population (4.9%). High blood-pressure, unhealthy weight, physical inactivity, and older age increased the risk for self-reported diabetes solely but also cumulatively.

Conclusion: It is important to identify individuals with a high risk of diabetes and put preventive efforts into combating risk factors for diabetes. Targeting specific risk factors significantly reduces the risk of developing this disease.

Introduction: Participation is one of the core elements of health promotion, which means that approaches and methods should focus on involvement. The process of involving women with a migration background in health promotion needs to be further explored. Thus, the aim of this study was to explore the development process of a type 2 diabetes health-promotive community-based participatory research intervention among Middle Eastern women with a migration background, living in Sweden. Materials and methods: This study was performed within the context of a community-based participatory research program in Sweden. The design of this study followed the development process of a community-based participatory research conceptual model, including three of the original four dimensions, that is, the context, the partnership process, and the intervention and research dimension. Appropriate methods for data collection were used in the various dimensions. Participants from the community, active in the program, conducted dialogue cafés, together with the core partners of the program, to inventory existing needs as well as what actions were needed for promoting health and thereby prevent type 2 diabetes. Results: The two dialogue cafes resulted in one long term and three short term goals. The third short-term goal—create health circles around food and nutrition was decided to be in focus for this study together with cooperation with the local health care center. The partnership process made it possible to involve relevant collaborators, which resulted in a jointly developed nurse-led educational intervention. Participants and stakeholders were also involved in the process of modifying and elaborating evaluation tools appropriate for the intervention. Discussion/conclusions: The community-based participatory research approach enables the acknowledgement and use of the various kinds of knowledge of all stakeholders, including the community members. In this study, the community members’ knowledge was obtained through participation and dialogue, aimed at balancing power between stakeholders. This approach, that is, developing a community-based participatory research intervention, offers a possibility for the primary health care to engage with the community members and for other stakeholders to work in a health-promotive way.

Aim: Type 2 diabetes is becoming more prevalent in many parts of the world. Malmö's population has increased in recent years mainly because of migration from other parts of Sweden and the world in addition to increased birth rates. We aimed to explore diabetes prevalence in Malmö in 2011-2018 as well as the achieved treatment targets for selected diabetes-related outcomes.

Method: The current study is a part of the Cities Changing Diabetes Malmö project. Prevalence data were retrieved from the region's primary care and hospital diagnosis register, and data on treatment targets were collected from the National Diabetes Register. The inclusion criteria were either being a resident of Malmö or using a primary healthcare centre located in Malmö.

Results: The prevalence of type 2 diabetes in 2018 doubled from 2011 in the entire Malmö population. During the same period, the prevalence of type 1 diabetes remained stable at 0.49 %. In 2011, the type 2 diabetes prevalence was 2.46 % (2.76 % for males and 2.28 % for females), and in 2018, it was 4.26 % (4.84 % for males and 3.82 % for females). The increase was 139 % for residents aged 0-29 years, 119.6 % for residents aged 30-39 years, 96.2 % for residents aged 40-49 years, 102 % for residents aged 50-59 years, 98.2 % for residents aged 60-69 years, and 115.5 % for those aged 70-79 years. Finally, the increase was 60.9 % for those aged 80-84 years and 90.7 % for residents 90 years of age and older. The National Diabetes Register reported that during 2019, 58 % of all patients with diabetes using primary care in Malmö reached HbA1c <52 mmol/mol, 20 % had albuminuria, 36 % had retinopathy, and 21 % had not had their feet inspected by a healthcare professional during the last year. The median HbA1c was 52.6 mmol/mol, and 17 % were registered as active smokers.

Conclusion: Diabetes prevalence in Malmö has increased markedly in recent years, exacerbated by a rise in type 2 diabetes mainly in the younger population. Targets regarding p-glucose lowering treatments were not met by 42 %. One patient out of three had microvascular complications in the eye, one out of five had impaired kidney function, one out of five had not had their feet inspected, and one out of five was an active smoker. Active diabetes treatments need to be improved to reduce the number of younger patients developing microvascular complications. Preventive activities need to target younger populations to counteract even more residents developing type 2 diabetes.