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.

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

Background: Nurse practitioners (NPs) play a crucial role in healthcare by providing person-centred and high-quality care. Their contributions encompass enhanced accessibility to healthcare and reduced hospital admissions and cost-effectiveness. They usually hold a master's degree in nursing, incorporating expanded clinical skills to manage patients in different settings and address both nursing and medical needs. Despite the global development of the role, its implementation varies, presenting challenges related to role clarity, regulation and acceptance by other healthcare professionals.

Aim: To explore how nurses who are or have been employed as NPs describe their experiences of transitioning to and working in the NP role in Sweden.

Design: A qualitative interview study.

Method: This study explores the experiences of 15 NPs in Sweden, using a snowball sampling strategy and semi-structured interviews. The data were collected through interviews in April and May 2022 and analysed with inductive content analysis.

Findings: The present study explores the experiences of NPs as they transition from experienced nurses to NPs, emphasising motivations, educational challenges, acceptance and autonomy. Transitioning into the NP role initially brought isolation that evolved into acceptance. They recognised their strength in integrating medical and nursing competencies for holistic care. Leadership was pivotal, with managerial support crucial for the successful implementation of the role. Autonomy-related challenges, such as prescription rights and dependency on physicians, underscored the need for a protected professional title and national guidelines.

Conclusion: This study enriches the evolution of the NP role in Sweden, offering vital insights into the ongoing national-level dialogues on NP role development in Sweden.

Impact: The paper's relevance extends globally by providing valuable perspectives on NPs practicalities and fostering international understanding and advancement.

Reporting method: Standards for reporting qualitative research.

Patient or public contribution: Not applicable.

Background: Relative's efforts are essential when palliative care is provided at home and support from healthcare professionals is needed. Despite this, since the support provided varies, relatives may have unmet support needs. Many people receive general palliative care at home rather than specialised care, and nurses play a significant role in supporting relatives. This study aimed to explore registered nurses' experiences of supporting relatives before and after a patient's death when general palliative care is provided at home.

Methods: This study used a qualitative explorative design. Data were collected through focus group interviews with 18 registered nurses in home care in Sweden and were analysed using content analysis. The Consolidated Criteria for Reporting Qualitative Research checklist was used for explicit reporting.

Results: The findings are presented in four categories with subcategories: receiving support to provide support, continuously providing understandable information, balancing different needs and building relationships facilitates safety and identifying needs.

Conclusions: Even if registered nurses support relatives to some extent, they rarely reflect on the support they provide and lack structure in providing support both before and after the patient's death. The findings showed inadequacies in support after the patient's death, which is also emphasised in previous studies. The findings also showed deficiencies in routines, local guidelines and checklists as well as in training and education on how to support relatives when palliative care is provided at home, thereby risking that relatives' needs remain unmet. This highlights the need for creating routines and developing detailed local guidelines and checklists on providing support to relatives both before and after the patient's death.

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.

Background: The nurse practitioner role has become important globally in handlingthe growing healthcare needs of older adults with chronic diseases. Nevertheless,research shows that introducing the role is a complex process, and more studies areneeded to prepare for its introduction into different healthcare contexts, such as municipalhealthcare.Aim: The aim is to investigate what Swedish stakeholders identify as the preparatorywork needed before introducing the nurse practitioner role into municipalhealthcare.Methods: Data were collected through four focus group interviews conducted virtuallyon the TEAMS digital platform, with three to six participants in each groupand 18 participants total. The transcribed interviews were analysed using a six-stepthematic approach: familiarisation with the data, coding the data, generating initialthemes, reviewing themes, defining and naming the themes and producing thereport.Findings: The findings are divided into two main themes, each with two sub-themes.In the first, clarifying why the nurse practitioner role is needed, participants stressedthe importance of having a clear intention for introducing the role. The second, ensurea national framework to bolster the introduction at the local level, demonstratesthe need for collaboration among national actors to clarify the role's mandate andauthority before its introduction.Conclusions: Adding the nurse practitioner role to municipal healthcare can helpincrease the supply of nursing competence and the quality of patient care, but preparationfor introducing the role requires extensive work. The development of thenurse practitioner role requires decision-makers and leaders to take primary responsibilityfor its introduction. This study can support countries in the early phase ofdeveloping the nurse practitioner role by identifying both best practices and pitfalls.

INTRODUCTION: Research suggests that participating in after-school leisure activities has been related to promoting health, well-being and safety among children living in disadvantaged neighbourhoods. The United Nations Child Rights Convention emphasises the inclusion of children in decisions that concern them. However, children seldom are involved in designing implementing and evaluating health promotional environments. The aim of this programme is through a participatory process with children, parents/guardians, and peer-activity leaders explore, measure and evaluate the impact on children's overall well-being related to the social context in an already established health promotion environments in Southern Sweden.

METHODS AND ANALYSIS: The project is based on a previously implemented unique community-based participatory research (CBPR) model for equal health in three socially disadvantaged areas in Malmö. All activity house (AAH) is a meeting place for children established in schools but after school time by the culture department of the Malmö municipality. In AAH migrant children participate in need-driven after school activities that they themselves create and develop. To increase participation of the children and ensure that these environments are based on their needs, 30 children (10-12 years), parents/guardians (30), peer-activity leaders (15), and researchers create CBPR teams in the areas and engage in a participatory process. The children reflect, analyse and write about their well-being; identify and discuss key factors in an iterative process, which also includes a strategic group of stakeholders. The children then develop and validate (with 100 other children from AAH) the Socioculturally Aligned Survey Instrument for Children survey inspired by the KIDSSCREEN V.27. The survey tool so developed will further be used to evaluate AAH and will be distributed to all children participating in their activities.

ETHICS AND DISSEMINATION: This programme has been approved by the Swedish Ethical Review Authority. The results from this programme will be published as reports and scientific publication.

INTRODUCTION: Existential loneliness (EL) is an unavoidable, deeper sense of loneliness. EL has been described as disconnection from life and the universe, experienced even in the presence of family and friends. Meaninglessness, loss of health and significant others seem to trigger older persons EL. Older Arabic-speaking women are a large migrant group in Sweden and there is a lack in knowledge about their experience of EL. Therefore, this study aimed to describe the phenomenon of EL as experienced by older Arabic-speaking female migrants.

METHODS: This study was based on a phenomenological approach known as reflective lifeworld research (RLR). Ten older migrated Arabic-speaking women were included in the study. Lifeworld interviews were conducted to collect data. The data were analysed in accordance with the phenomenological RLR principles of openness, flexibility and bridling.

RESULTS: This study shows that EL is experienced when there is a lack of attachment to place and people. EL is experienced more distinctively in the beginning of the migration process. It was difficult sharing feelings of EL with anyone. Feelings of meaninglessness occurred when entering a new lifeworld and triggered EL. EL was however attenuated when being able to practise their religion.

CONCLUSION: Lack of attachment to place and people as well as feelings of meaninglessness brought existential loneliness to the fore for the older Arabic-speaking female migrants. There was a collision of lifeworlds not at least by the fact moving as a Muslim woman to one of the most secular countries in the world. Practising their religion attenuated their EL. To promote better health for this group of women, it is of importance to be aware of EL and its mode of expression.

IMPLICATIONS FOR PRACTICE: It is crucial to let the voice of older Arabic-speaking female migrants be heard and to be aware of their experience of EL and its mode of expression in order to promote better health. Further, educational training for nursing professionals and nursing students needs to be provided to develop skills how to be aware of and address EL.

Introduction: Social determinants of health impact health, and migrants are exposed to an inequitable distribution of resources that may impact their health negatively, leading to health inequality and social injustice. Migrant women are difficult to engage in health-promotional activities because of language barriers, socioeconomic circumstances, and other social determinants. Based on the framework of Paulo Freire, a community health promotion program was established in a community-academic partnership with a community-based participatory research approach.

Aim: The aim of this study was to describe how a collaborative women's health initiative contributed to migrant women's engagement in health promotion activities.

Materials and methods: This study was part of a larger program, carried out in a disadvantaged city area in Sweden. It had a qualitative design with a participatory approach, following up on actions taken to promote health. Health-promotional activities were developed in collaboration with a women's health group, facilitated by a lay health promoter. The study population was formed by 17 mainly Middle Eastern migrant women. Data was collected using the story-dialog method and the material was analyzed using thematic analysis.

Result: Three important contributors to engagement in health promotion were identified at an early stage of the analysis process, namely, the group forming a social network, the local facilitator from the community, and the use of social places close to home. Later in the analysis process, a connection was made between these contributors and the rationale behind their importance, that is, how they motivated and supported the women and how the dialog was conducted. This therefore became the designated themes and were connected to all contributors, forming three main themes and nine sub-themes.

Conclusion: The key implication was that the women made use of their health knowledge and put it into practice. Thus, a progression from functional health literacy to a level of critical health literacy may be said to have occurred.

Background Citizens with low levels of social capital and social status, and relative poverty, seem to have been disproportionally exposed to COVID-19 and are at greater risk of experiencing poor health. Notably, the incidence of COVID-19 was nearly three times higher among citizens living in socially vulnerable areas. Experiences from the African Ebola epidemic show that in an environment based on trust, community partners can help to improve understanding of disease control without compromising safety. Such an approach is often driven by the civil society and local lay health promoters. However, little is known about the role of lay health promoters during a pandemic with communicable diseases in the European Union. This study had its point of departure in an already established Community Based Participatory Research health promotion programme in a socially disadvantaged area in southern Sweden. The aim of this study was to explore how citizens and local lay health promoters living in vulnerable neighbourhoods responded to the COVID-19 pandemic a year from the start of the pandemic.Method In-depth interviews with the 5 lay health promoters and focus group discussions with 34 citizens from the neighbourhood who were involved in the activities within the programme were conducted in autumn 2020. The interviews and focus group discussions were transcribed verbatim and analysed using qualitative content analysis following an inductive approach.Results Four themes emerged including, 'balancing between different kinds of information', 'balancing between place-based activities and activities on social media', 'bridging between local authorities and the communities and community members', and 'balancing ambivalence through participatory dialogues'.Conclusion The study highlights that a Community Based Participatory Research programme with lay health promoters as community trust builders had a potential to work with communicable diseases during the pandemic. The lay health promoters played a key role in promoting health during the pandemic by deepening the knowledge and understanding of the role that marginalised citizens have in building resilience and sustainability in their community in preparation for future crises. Public health authorities need to take the local context into consideration within their pandemic strategies to reach out to vulnerable groups.