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.