Culture- and evidence-based health promotion group education perceived by new-coming adult Arabic-speaking male and female refugees to Sweden—Pre and two post assessments

Abstract

Objective: According to a theoretical approach, events that elicit stress after arrival in the re- ception country, i.e., post-migration stress, have a negative impact on health-related quality of life among newly-arrived refugees. With the aim of paying attention to such symptoms, a revised culturally-tailored clinical health promotion model developed at Harvard Program in Refugee Trau- ma was used for invited groups of new-coming adult refugees in a town south of the Swedish capital. Methods: A coordinator administered the five-weekly sessions, 2 hours/week, with a professional interpreter. It covered major topics from Western and Arabic worldviews: 1) intro- duction; 2) health care: organisation and access to; 3) exercises; 4) stress management and coping, 5) medical doctor-patient communica- tion. Each topic was led by a nurse, a physio- therapist, a psychologist and a physician with experience of encounters with this target group in health care. Data cover results from 70 par- ticipants attending six groups; 39 participants with pre-course findings and, post-course and six-month follow-ups. There were no significant differences in background factors between the participants and the drop-outs. Results: Partici- pants’ perceptions of their health, measured by EQ-5D, changed positively over time, above all immediately after the course, with no significant differences between the two follow-ups. In the follow-ups, female participants perceived their health as significantly worse than males. Quali- tative data at the six-month follow-up assessed the course as useful but expressed a wish to * Competing interests: the authors have no competing interests. continue a similar course with a focus on post- migration stress. Conclusion: The results sup- port earlier findings. A course, administered to a small group in a dialogue setting, has value for the participants’ empowerment and perception of health. It is recommended that reception be more adapted to coping of post-migration stress of new-coming refugees. Practical Implications: The results have implications for education in clinical health promotion, intercultural commu- nication and inter-professional collaboration in refugee