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Exploring how people achieve the recommended levels of physical activity despite self-reported economic difficulties: a sense of coherence perspective
Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Unit for Research and Development in Primary Care, Futurum - Academy for Health and Care, Region Jönköping County, Jönköping, Sweden.ORCID iD: 0000-0001-5834-7494
Jönköping University, School of Health and Welfare, HHJ, Department of Clinical Diagnostics. Jönköping University, School of Health and Welfare, HHJ. Studies on Integrated Health and Welfare (SIHW).ORCID iD: 0000-0001-9042-4832
Unit for Research and Development in Primary Care, Futurum - Academy for Health and Care, Region Jönköping County, Jönköping, Sweden.
Jönköping University, School of Health and Welfare, HHJ, Department of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD. Child Health Service and Futurum - Academy for Health and Care, Region Jönköping County, Jönköping, Sweden.ORCID iD: 0000-0002-0156-6677
2024 (English)In: BMC Primary Care, E-ISSN 2731-4553, Vol. 25, no 1, article id 105Article in journal (Refereed) Published
Sustainable development
00. Sustainable Development, 3. Good health and well-being
Abstract [en]

Background

The salutogenic theory forms the basis for health promotion and describes health as a continuum from a dis-ease pole of health to an ease pole. The core concept for the salutogenic theory is sense of coherence (SOC). For a strong SOC, general resistance resources, such as solid economic situation, are essential. The aim was to explore how people – despite self-reported economic difficulties – comprehend, manage and find it meaningful to achieve the level of physical activity recommended by World Health Organisation (WHO).

Method

The study is based on interviews with people achieving the recommended physical activity (PA) level despite economic difficulties. The interviews were conducted at primary health care centres and family centres after a targeted health dialogue. We used a qualitative deductive content analysis based on sense of coherence as the main category, with the three generic categories of comprehensibility, manageability and meaningfulness.

Result

The findings elucidate a pattern of a process. In this process, the participants comprehend their knowledge of the health benefits of PA and have a plan for performing their PA. They utilise their resources in order to manage to apply their knowledge and plan for PA in their lives despite their challenges. When PA becomes meaningful to them, they have an intrinsic motivation to perform it and experience its benefits.

Conclusion

This study suggests a possible process that might help in achieving the recommended PA level among people with economic difficulties and other challenges. The findings might be used in health promotion work, such as targeted health dialogues in primary health care, to reduce health inequalities when supporting people who are not achieving the recommended levels of PA.

Trial registration

Not applicable.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024. Vol. 25, no 1, article id 105
Keywords [en]
Sense of coherence, Physical activity, Deductive content analyse, Economic difficulties, Health promotion
National Category
Nursing Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:hj:diva-63763DOI: 10.1186/s12875-024-02354-zISI: 001197504700002PubMedID: 38575903Scopus ID: 2-s2.0-85189644392Local ID: GOA;;1843101OAI: oai:DiVA.org:hj-63763DiVA, id: diva2:1843101
Funder
Futurum - Academy for Health and Care, Jönköping County Council, Sweden, FUTURUM-936841, FUTURUM-971225, FUTURUM-971225, FUTURUM-981886
Note

Included in doctoral thesis in manuscript form.

Available from: 2024-03-07 Created: 2024-03-07 Last updated: 2024-04-15Bibliographically approved
In thesis
1. To do or not to do? Physical activity in relation to socioeconomic status and health – a salutogenic perspective in the context of targeted health dialogues
Open this publication in new window or tab >>To do or not to do? Physical activity in relation to socioeconomic status and health – a salutogenic perspective in the context of targeted health dialogues
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

It is well known that physical activity (PA) has a major positive impact on health and that the performance of PA is lower in low socioeconomic groups. However, more knowledge about the relationship between PA and health is needed especially between and within socioeconomic groups.

This thesis aimed, from a salutogenic perspective, to increase the understanding of the relationship between physical activity and health in the adult population, with a particular focus on people with economic difficulties. A further aim was to validate questions about physical activity and to explore the people’s experiences of PA from a sense of coherence perspective, all in the context of targeted health dialogues.

The first study in this thesis is a validation study. It validates a PA interview form and questions about sedentary time used in the targeted health dialogues. Studies II and III comprise quantitative analyses of PA, health and psychological factors in the population, especially in groups with low socioeconomic status (SES). Study IV is a qualitative deductive study based on interviews with participants with low SES in the targeted health dialogues. The deductive analysis contains the participants’ experiences of PA from a sense of coherence perspective.

The findings in study I showed that the interview form and the single-item question about sedentary time could be considered as acceptable to use in Swedish targeted health dialogues. In study II, physically active people with low SES were shown to have the same odds of reporting good self-rated health compared to those with low PA and high SES. The findings in study III showed that within the group of people with self-reported economic difficulties, higher levels of PA were related to better mastery and more vitality. Study IV showed that it is essential for the participants to have an awareness of the health benefits of PA and their challenges in performing PA. The participants also constructed a plan to follow while utilising their resources, and their intrinsic motivation to achieve the PA recommendations and the PA benefits.

This thesis brings a deeper knowledge and understanding of the healthperspective of PA. This knowledge can be used to further develop thetargeted health dialogues in a salutogenic way. It will give people,especially those with lower SES, the opportunity to use their resourcesto increase PA and thereby improve their future health.

Place, publisher, year, edition, pages
Jönköping: Jönköping University, School of Health and Welfare, 2024. p. 93
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 133
Keywords
health, mastery, physical activity, quality of life, salutogenesis, self-rated health, sense of coherence, targeted health dialogues, vitality
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hj:diva-63764 (URN)978-91-88669-41-4 (ISBN)978-91-88669-42-1 (ISBN)
Public defence
2024-04-05, Forum Humanum, School of Health and Welfare, Jönköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2024-03-07 Created: 2024-03-07 Last updated: 2024-03-07Bibliographically approved

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Johansson, LisbethFransson, Eleonor I.Golsäter, Marie

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