A controlled weight loss intervention study among women of Somali background in Norway.

Background: Women of Somali background in Norway have a high prevalence of overweight and obesity, compared with women in the general Norwegian population. For lifestyle interventions to be applicable for immigrants to Norway, it is important to culturally tailor interventions in collaboration with relevant communities. The primary outcome was a difference in weight change between the intervention and control groups. Methods: In this interventional study, Somali women living in one borough of Oslo Municipality in Norway with body mass index (BMI) ≥27.0 kg.m-2 received a co-created, culturally tailored 12-month weight loss intervention consisting of 24 interactive sessions during the first three months, and monthly sessions for the next nine months, compared to a control group. Both groups were measured at baseline and 12 months. Results: A total of 169 participants were recruited, and 101 participants completed the follow-up. After multiple imputation, the mean difference in weight change adjusted for baseline weight, age, education, employment, marital status, number of children in the household and length of Norwegian residency was -1.6 kg (95 % CI -3.57, 0.43, p = 0.12) in the intervention compared to the control group. Conclusion: This culturally tailored intervention study demonstrated a modest non-significant effect on weight change after 12 months, possibly due to the short intervention duration and COVID-19. Further studies of a longer duration and considering the provision of childcare are needed to understand whether this approach can be transferred to other immigrant groups and genders.Trial registration: The study was registered at clinicaltrials.gov NCT04578067, 2020-09-29.

Changing praxis from within - an in-depth qualitative exploration of how home visits affected statutory service at a Child Health Clinic.

PURPOSE: This study aims to define critical domains of salutogenic home visits conducted by public health nurses, and how thevisits can supplement a universal Child Health Clinic. DESIGN AND METHOD: A qualitative grounded theory study was conducted among three public health nurses in Stovner district, Oslo, Norway. The nurses were followed for 26 months offering home visits to all first-time parents. Data from focus group discussions, monthly reflection notes and bi-weekly meeting minutes were analysed using qualitative content analysis. RESULTS: Three critical themes emerged: building trust, prenatal visits and maintaining a salutogenic, strength-based approach. Extended public health nurse autonomy facilitated tailored support based on individual family needs. This promoted proportionate universalism to naturally be the gradient of the home visit intensity and kept actions at a universal level. CONCLUSIONS: The key component of family access and utilizing support was building and maintaining trust. Conducting prenatal visits was an important part of the nurse-family relationship, positively affecting later Child Health Clinic follow-up and continued care. PRACTICE IMPLICATIONS: Critical domains and benefits of practicing home visits emerged in this study and disclosed important aspects necessary for family access and utilizing support. By changing the point of entry from postnatal to prenatal, public health nurses-family relationship gets an important head start, positively affecting later follow-up and continued care. A tailored support to new families without using a predefined agenda and a salutogenic, strength-based philosophy can fit the public health nurses' professional beliefs and extend their autonomy.

Look to Norway: Serving new families and infants in a multiethnic population.

Despite recognition that immigrant women face significant health challenges, addressing the healthcare needs of immigrants is a source of debate in the United States. Lack of adequate healthcare for immigrants is recognized as a social justice issue, and other countries have incorporated immigrants into their healthcare services. Oslo, the fastest growing capital in Europe, is rapidly shifting to a heterogeneous society prompting organizational action and change. The New Families Program serves first-time mothers and their infants in an Oslo district serving 53% minorities from 142 countries. Anchored in salutogenic theory, the program aims to support the parent-child relationship, children's development and social adaptation, and to prevent stress-related outcomes. Formative research has informed the successful program development and implementation within the existing maternal and child healthcare service. Implications for addressing maternal and child health needs of an immigrant population are presented.

A pesar de reconocerse que las mujeres inmigrantes enfrentan significativos retos en cuanto a salud, las discusiones sobre las necesidades de cuidado de salud de inmigrantes es fuente de debate en Estados Unidos. La falta de un adecuado sistema de cuidado de salud para inmigrantes es identificado como un asunto de justicia social y otros países han incorporado a los inmigrantes dentro de sus servicios de cuidado de salud. Oslo, la capital europea con mayor crecimiento, está pasando rápidamente a ser una sociedad heterogénea lo cual conlleva acción y cambios organizacionales. El programa las Nuevas Familias ayuda a madres primerizas y sus infantes en un distrito de Oslo que sirve a un 53% de grupos minoritarios de 142 países. Basado en la teoría salutogénica, el programa se propone apoyar la relación madre-niño, el desarrollo y la adaptación social de los niños, así como prevenir resultados relacionados con el estrés. La investigación formativa es la base del éxito del desarrollo e implementación del programa dentro del existente servicio de cuidado de salud materno e infantil. Se presentan las implicaciones para discutir las necesidades de salud materno-infantiles de una población inmigrante.

Bien qu'il soit reconnu que les femmes immigrées font face à des défis de santé importants, le fait de considérer les besoins de santé des immigrés est une source de débat aux Etats-Unis. Le manque de soins de santé pour les immigrés est reconnu comme étant une question de justice sociale et d'autres pays ont incorporé les immigrés dans leurs services médicaux. Oslo, en Norvège, la capitale européenne qui grandit le plus vite, est rapidement en train d'évoluer vers une société hétérogène exigeant une action organisationnelle et des changements. Le programme des Nouvelles Familles sert des mères étant mères pour la première fois et leurs nourrissons dans une partie de la ville d'Oslo qui contient 53% de minorités venues de 142 pays. Ancré dans une théorie de salutogénèse, ce programme a pour but de soutenir la relation parent-enfant, le développement des enfants et leur adaptation sociale, et de prévenir des résultats liés au stress. Des recherches formatives ont influencé le succès du développement du programme ainsi que sa mise en place au sein d'un service de soins maternels et de l'enfant existant déjà. Les implications concernant l'approche des besoins de santé pour les mères et les enfants de cette population immigrée sont présentées.

Formative research in the development of a salutogenic early intervention home visiting program integrated in public child health service in a multiethnic population in Norway.

BACKGROUND: Few early intervention programs aimed at maternal and child health have been developed to be integrated in the existing Child Health Service in a country where the service is free, voluntary and used by the majority of the eligible population. This study presents the process and the critical steps in developing the "New Mothers" program. METHODS: Formative research uses a mixed method, allowing us to obtain data from multiple sources. A scoping review provided information on early intervention programs and studies, clarifying key elements when framing a new program. Key informant and focus group interviews offered insight of existing challenges, perceptions, identified power structures and offered reflections germane to the identified framework, securing user involvement at all stages. Monthly meetings with the project group enabled feedback loops for the data, securing program advancement. RESULTS: The "New Mothers" program was formed based on a salutogenic theory, emphasizing resistance and strengths. Public health nurses in the existing Child Health Service were to offer universally all first-time mothers and children home visits from gestational week 28 until the child reached 2 years, with motivational interviewing and empathic communication as methods to mentor the mothers, help them identify their strengths and resources, and provide support and information. CONCLUSIONS: Using formative research as mixed method ensures incorporation of detailed information from multiple resources when an early intervention program is developed. This method secured program appropriateness, both culturally and at system level, when integrating new elements in the existing service.