Grønlandske gymnasieelevers betydningsdannelse af sundhed – Udvikling af en kompleks intervention i et sundhedsfremmende forandringsperspektiv

Abstract

Titel: Grønlandske gymnasieelevers betydningsdannelse af sundhed – Udvikling af en kompleks intervention i et sundhedsfremmende forandringsperspektiv Problemstilling: I den grønlandske befolkning ses en stigning af kardio-metaboliske risikofaktorer. Herunder ses der en stigning i fedme og overvægt blandt unge i Grønland, hvortil flere er blevet fysisk inaktive samtidig med, at der ses en stigning i indtagelsen af usund kost blandt grønlandske unge. Ydermere er grønlandske unge de, der spiser mindst frugt og grønt og ryger mest sammenlignet med unge i resten af Europa. Formål: Specialets formål er at belyse grønlandske gymnasieelevers betydningsdannelse af sundhed, for derigennem at finde mulige forandringspotentialer, mhp. at udvikle en sundhedsintervention til et udvalgt gymnasium. Interventionen har til formål at forandre elevernes sundhedsadfærd, således deres risikofaktorer reduceres, hvorved deres sundhed kan fremmes. Metode: Specialets design er et casestudie, hvorunder datagenereringsmetoderne bestod af to fokusgruppeinterviews og 14 dages deltagerobservation på et udvalgt gymnasium i Grønland. Ydermere bidrog et systematisk litteraturstudie med relevante studier til at udvikle en kompleks intervention. I specialet blev der anlagt et konstruktivistisk-interaktionistisk perspektiv. Specialets teoretiske referenceramme tog afsæt i begreber af Erving Goffman. Perspektivet og teorien bidrog til at opnå forståelse for elevernes konstruktion og betydningsdannelse af sundhed gennem deres interaktion med hinanden og med konteksten. Resultat: Af elevernes betydningsdannelse fremgik det, at sundhed bl.a. bestod af sund kost, fysisk aktivitet, et moderat stressniveau samt nære relationer. Mange af eleverne købte og indtog usunde fødevarer på gymnasiet. Endvidere røg en stor del af gymnasiets elever ved det centralt placerede rygeskur, hvortil det sociale aspekt synes at være af betydning. Med afsæt i empirien samt de udvalgte studier blev der udviklet en kompleks intervention målrettet kost og rygning for derigennem at ændre elevernes sundhedsadfærd med henblik på at fremme deres sundhed. Konklusion: Den komplekse intervention til gymnasiet kan bidrage til forandring i form af ændret sundhedsadfærd blandt eleverne og bør indeholde aktiviteter, der sigter mod reducering af rygning samt et øget indtag af sund kost i hverdagen på gymnasiet. Disse aktiviteter bør have fokus på det sociale aspekt og på ændring af gymnasiets rammer. For at influere flest mulige elever kan den komplekse intervention med fordel lade sig udforme som en strukturel forebyggelsesstrategi. Ydermere blev der påvist forandringspotentialer i henhold til stress, mere fysisk aktivitet samt mere oplysning på gymnasiet om de udbudte aktiviteter. Disse kan danne afsæt for udvikling af en senere intervention. Endvidere kan andre grønlandske gymnasier, der har forandring af elevernes sundhedsadfærd som sigte, finde inspiration i den udviklede komplekse intervention.

Abstract Title: Greenlandic high school students perceptions of health – Development of a complex intervention in a health-promoting change perspective Problem: In the Greenlandic population an increase in the cardio-metabolic risk factors is observed. An increase in obesity is seen among adolescents in Greenland and an increasing number of adolescents are becoming physically inactive. In addition to this, the intake of unhealthy diet is increasing too. Furthermore the Greenlandic adolescents are the adolescents in Europe with the lowest consumption of fruits and vegetables and have the highest prevalence of young smokers. Objective: To investigate the perceptions of health among Greenlandic high school students and use these perceptions in the development of a complex health intervention for a high school in Greenland. The intervention will aim to change the health behaviour among the students in a way where risk factors will be reduced whereby health will be promoted. Methods: The research design is a case study. Qualitative methods were used and consisted of two semi structured focus group interviews and 14 days of participant observation on a high school in Greenland. The MRC-model was used in order to develop the complex intervention. Furthermore, a systematic review was carried out in order to identify health interventions in high schools on an international level. In the thesis a constructivist-interactionism perspective was chosen. The theoretical framework of the study is based on Erving Goffman. The perspective and the theory contributed to gain knowledge of how the students constructed their perception of health through their interaction with each other and through the interaction with the context. Results: From the students perceptions it emerged that health consisted of a healthy diet, physical activity, moderate stress and close relationships. In contrast, many of the students bought or brought unhealthy food to the high school and in addition to this, a large proportion of the students were smokers and they socialised among smoking in the smoking area. For these reasons a complex intervention was developed in order to change the students health behaviour regarding smoking and diet in a health-promoting way. Conclusion: The complex intervention developed to the high school can contribute to change the health behaviour among the students and should include health-promoting activities that aim to reduce smoking and increase intake of healthy diets among the students. These activities should focus on social factors and changes in the high school environment. In order to influence as many students as possible, the intervention could be formulated as a structural prevention strategy. Furthermore, change potentials were shown in terms of stress, more physical activity and more information about the current activities offered in the high school. These areas can form the basis of development of a later intervention. Other high schools in Greenland that posses an ambition to change health behaviour among the students, can find inspiration in the developed complex intervention.

A master thesis from Aalborg University

Grønlandske gymnasieelevers betydningsdannelse af sundhed – Udvikling af en kompleks intervention i et sundhedsfremmende forandringsperspektiv

[Greenlandic high school students perceptions of health – Development of a complex intervention in a health-promoting change perspective]