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Background: Sex workers in South Africa face various forms of structural and interpersonal violence, including police violence, exclusion from health services, and stigmatization and marginalization within their communities. In an attempt to counteract the harmful health effects of criminalization and exclusion, risk-reduction workshops are a key component of HIV prevention programs globally. This paper offers a critical investigation of Creative Space workshops – a South African model of risk-reduction workshops for sex workers – taking place in Soweto, Johannesburg. Drawing on Paulo Freire's work, the paper explores the potential of these workshops to contribute to the empowerment, health and well-being of sex workers. Objectives: The aim of this paper is to investigate the social and psychological effects of peer-led risk-reduction workshops for sex workers in Soweto, South Africa, with a particular focus on the ways in which they might contribute to community empowerment. Methods: This paper is based on in-depth interviews and focus group discussions with 32 sex workers conducted as part of a 20-month ethnographic study (December 2015 to July 2017). Data was analyzed combining inductive thematic analysis with a theoretical frame based on Freire's theory of community empowerment. Results: Peer-led risk-reduction workshops can serve as a 'safe space' for sex workers and distribute empowering forms of knowledge, particularly regarding health issues and rights. However, divisions between different groups of sex workers and between sex workers and non-sex workers counteract the potential benefits of the workshops. Conclusions: Peer-led sex worker programs are likely to be more empowering when they are committed to raising critical consciousness and creating solidarity, and embedded in community action, focusing on common issues such as institutionalized racism, livelihood insecurity, and lack of access to safe and secure housing. Such actions would have positive outcomes on health and well-being. [ABSTRACT FROM AUTHOR]

Copyright of Critical African Studies is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Participation of local actors has shown to be of significant importance to the uptake of new approaches to agricultural initiatives in developing countries. This paper proposes a new approach to empower local chain actors to work together to understand their own and others' challenges, to pursue common understanding of their situations and challenges, and to then co-create solutions. Reflection on each other's position is crucial to this process, and is core to the participatory approach designed to this purpose. Agricultural chains are the focus of a case study in Indonesia involving both farmers and wholesalers in the chain. Results show that the approach has led to new forms of collaboration between farmers, and between farmers and wholesalers, increasing market potential. [ABSTRACT FROM AUTHOR]

Mental illness is increasing worldwide, while society’s response seems to be a trend toward narrower and more specialized mental health care. This development is creating great demands on mental health nurses to include a health promotion perspective in care and support of persons with mental illness. A health promotion perspective emphasizes cooperation and communication with people who suffer from long-term mental illness, focusing on their independence and health. From a health perspective, every human being is an actor in his/her own life, with an inherent ability to make his/her own choices. However, persons who suffer from long-term mental illness are at risk of losing power and control over areas of their lives and their health. Mental health nurses are in a position to support these individuals in promoting health and in maintaining or regaining control over their lives. The emphasis of this paper is to problematize mental health nurses’ responsibility to provide health-promoting nursing care in relation to empowerment by means of emancipation, self-efficacy, and self-management. We argue that mental health nurses can work from a health-promoting perspective by using these concepts and that this challenges some of the traditional ideas of health promotion in mental health nursing. The theoretical background discussions in this paper have their origin in the research network ‘‘Mental Health Nursing Research in Scandinavia’’ (MeHNuRse) and from the professional discussions developed during a 2012 workshop that included mental health nurses and researchers at the European Horatio Festival in Stockholm. [ABSTRACT FROM AUTHOR]

The limited impact of traditional extension techniques has resulted in the increasing use of participatory approaches to support interaction between Māori communities and scientists. This paper draws on the experience of a 5 year case study of such an approach among scientists and Māori on the East Cape. While supporting the value of a participatory approach, the paper argues that the adoption and use of such an approach must be viewed as an iterative process and one that challenges all participants, not only on operational detail, but on the ethical issues posed by such work. This paper highlights the value of a collaborative approach but questions the appropriateness of branding all such approaches as participatory research when used to support national policy initiatives. It concludes that participatory approaches challenge the scientists involved as much as the communities concerned and questions the validity of conventional measures of success in any evaluation of such work. [ABSTRACT FROM AUTHOR]

Evidence from a meta-analysis suggested that lesbian, gay, bisexual, transgender, and queer (LGBTQ+) youth experience elevated levels of victimization in schools as compared to their heterosexual peers, and that victimization was shown to be persistent and lasting, indicating that school environments are hostile. These findings point to the need to better understand youths' own efforts in becoming more aware and engaged in impacting systemic inequities. Photovoice and mobile interviewing, two relatively novel qualitative methodologies in the field of LGBTQ research, are methodologies that involve the participants by 1) taking photos of interest as a means of critical discussion, and 2) moving alongside the researcher in a participant-chosen area and have critical discussions highlighted by the visual cues. The goal of this paper is to highlight ways of listening to opinions of LGBTQ youth that are contextualized in the environments in which they are victimized. [ABSTRACT FROM AUTHOR]

Cost-efficient and multimedia-rich interaction opportunities offered by the Internet and the existence of online communities have made virtual co-creation a suitable means of creating value and improving the overall success of new products. Information technology enables new forms of producer--consumer collaboration in new product development processes. However, little research exists on consumers' experiences during virtual co-creation tasks. Drawing on the literature on organizational behavior, we introduce the construct of consumer empowerment to describe consumers' perceived influence on product design and decision making. This paper presents the first large-scale empirical study investigating how consumers are empowered through Internet-based co-creation activities. To analyze the impact of applied interaction tools, 727 consumers having taken part in virtual co-creation projects were asked about their experienced tool support, their perceived empowerment, how much they enjoyed the task, and their readiness to participate in future co-creation opportunities. The results show that consumers engaging in co-creation feel more or less empowered. The level of experienced empowerment depends on the design of the applied virtual interaction tool, the related enjoyment of the virtual interaction, the participants' task and product involvement, as well as their creativity and lead-user characteristics. The design of the interaction tool determines to what extent consumers with varying capabilities are able to solve the assigned co-creation task. It determines the consumers' perceived empowerment and experienced enjoyment. Both the levels of perceived empowerment and enjoyment have a strong impact on the consumers' willingness to participate in future virtual new product development projects. These findings contribute to a better understanding of antecedents and consequences of successful consumer co-creation. They provide recommendations on how to design a compelling virtual new product co-creation experience. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the acceptability of two co-designed mobile applications Mit Sygehus [a knowledge-based solution] and Genoptræn.dk [a self-training solution] to support a cross-sectoral, person-centred and empowering stroke rehabilitation. Setting: The applications were implemented and tested throughout two stroke rehabilitation trajectories in Southern Denmark, comprising two acute, two sub-acute and two municipal stroke rehabilitation settings. Methods, participants and analysis: A process evaluation focusing on acceptability was conducted. Individual and dyadic interviews were performed with ten stroke survivors (three women and seven men, aged 50-84) with moderate stroke and seven significant others (five women and two men, aged 50-78) post-rehabilitation. A constructivist Grounded Theory analysis was used to explore what, why, when, and how the apps worked or did not work throughout the stroke rehabilitation trajectory and if adaptions were needed. Results: Participants found that Mit Sygehus provided adequate and sufficient knowledge and was easy to use, however, acceptability of Mit Sygehus declined throughout the rehabilitation process. Also, knowledge on 'return-to-work' and 're-gaining driver's license/permission to drive' needed to be developed. The content in Genoptræn.dk was perceived as acceptable, through content being person-centred, motivating and meaningful. Genoptræn.dk furthermore, supported the transfer between rehabilitation settings, provided a sense of progress throughout the rehabilitation process, facilitated positive habits regarding self-training, and relieved the burden on significant others. Genoptræn.dk was perceived most acceptable in the sub-acute rehabilitation setting and declined when rehabilitation continued in the municipal setting. Conclusion: Stroke survivors and their significant others found Mit Sygehus and Genoptræn.dk acceptable to support cross-sectoral, person-centred and empowering stroke rehabilitation, however acceptability declined throughout the rehabilitation process. Further investigations are required to determine how cognitive rehabilitation can play a greater role in app-supported stroke rehabilitation and how the need for more long-term follow-up can be supported. [ABSTRACT FROM AUTHOR]

In India, nurses and midwives are key to the provision of public sexual and reproductive health services. Research on impediments to their performance has primarily focused on their individual capability and systemic resource constraints. Despite emerging evidence on gender-based discrimination and low professional acceptance faced by these cadres, little has been done to link these constraints to power asymmetries within the health system. We analysed data from an ethnography conducted in two primary healthcare facilities in an eastern state in India, using Veneklasen and Miller's expressions of power framework, to explore how power and gender asymmetries constrain performance and quality of care provided by Auxiliary Nurse Midwives (ANMs). We find that ANMs' low position within the official hierarchy allows managers and doctors to exercise "power over" them, severely curtailing their expression of all other forms of power. Disempowerment of ANMs occurs at multiple levels in interlinked and interdependent ways. Our findings contribute to the empirical evidence, advancing the understanding of gender as a structurally embedded dimension of power. We illustrate how the weak positioning of ANMs reflects their lack of representation in policymaking positions, a virtual absence of gender-sensitive policies, and ultimately organisational power structures embedded in patriarchy. By deepening the understanding of empowerment, the paper suggests implementable pathways to empower ANMs for improved performance. This requires addressing entrenched gender inequities through structural and organisational changes that realign power relations, facilitate more collaborative ways of exercising power, and create the antecedents to individual empowerment. [ABSTRACT FROM AUTHOR]

This keynote address was presented by Wayne Fairhead for the 1994 National Conference of NADIE, the National Association for Drama in Education (now Drama Australia) held in Fremantle, Western Australia. It explores the concepts of empowerment in drama and theatre education and contextualises Australian curriculum developments in 1994, through sharing experiences from the development of Dramatic Arts Standards in Ontario, Canada. This paper is published in 2021 for its ongoing relevance to the ongoing development of the Australian Curriculum: The Arts (ACARA) and contemporary questions about the potential for empowerment through education. The introduction and footnotes contextualises the original keynote and contemporary issues. [ABSTRACT FROM AUTHOR]

Copyright of Critical African Studies is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Health inequalities arise already during the first thousand days of a child's life. Participatory action research (PAR) is a promising approach, addressing adverse contexts that impact health inequalities. This article describes the experience of mothers involved in a PAR process to develop a health promotion action that supports both children's and mothers' health. It also describes the experiences of mothers who attended the developed action and trainers who facilitated it. The PAR process resulted in the development of a sustained action called Mama's World Exercise Club aimed at promoting the health of mothers and their children. Results showed that the PAR process empowered the mothers and gave them a sense of pride at playing a useful role in their community. The developed action was highly valued by other mothers in the neighbourhood and widely implemented. These positive results can be ascribed to the strong collaboration between the researchers and the mothers, and the willingness of local stakeholders to support the action. Future studies should investigate if the results of this study sustain over a longer period of time and improve health outcomes of children and mothers in the long run. [ABSTRACT FROM AUTHOR]

Too often the minimum wage is conceived of as a small policy measure that will be of benefit to only a small segment of the labor market while imposing costs on another segment of the labor market. Unexplored, however, are the larger philosophic questions that such a small measure may actually raise. One such issue is the relationship between the minimum wage and democratic principles. In this paper I argue that the minimum wage furthers the ends of democratic society in that low-wage workers may achieve greater equality of standing with their piers to the extent that income inequality is at all lessened; their autonomy as individuals is enhanced through higher wages, which in turn enables them to claim the benefits of citizenship and participate more effectively in the democratic process; and it fosters greater economic development in that it raises the overall structure of a region and perhaps the productivity of that region. [ABSTRACT FROM AUTHOR]

Gestational diabetes (GDM) refers to glucose intolerance of varying severity first occurring in pregnancy. Following a diagnosis of GDM, exercise and dietary modification has a positive effect on improving glycemic control. Lifestyle changes affected in pregnancies affected by GDM have beneficial effects on long-term health if continued following birth. In addition, the psychological impact of a diagnosis of GDM should not be overlooked. Reports of maternal stress, anxiety, and fear are commonly reported issues in the literature. Support, both socially and from health care professionals, is also linked with higher rates of success in GDM management. Research to date had focused on women's reaction to a diagnosis of GDM, their mood and quality of life following a diagnosis, and their knowledge or opinions on the management of GDM. This qualitative study explored the attitudes of women with GDM toward these lifestyle changes, specifically diet and exercise. Women were also asked to identify advice that would be useful for other women newly diagnosed with GDM. With ethical approval a qualitative study was conducted using semi-structured interviews which were examined using Thematic Analysis. Patients were invited to participate and gave written consent after a discussion with a study researcher. The question plan for semi-structured interviews was designed with the advice of patient advocates. Recurrent themes were developed until the saturation of data. Thirty-two women took part in the study. Time, convenience, and lack of educational awareness were common barriers to healthy eating and physical activity plans. Enablers for change included meal planning and organization. Women regarded their diets pre-diagnosis as healthy, with small "tweaks" (such as portion control) required to comply with recommendations. Another significant facilitator to change was support from the woman's partner. This also set a benchmark for plans of diet maintenance within the family structure after pregnancy. Unlike dietary changes, a consistent theme was that exercise was considered a "chore" in managing GDM and was unlikely to be continued in the long term. Practical advice offered by participants for other women with GDM included organization, realistic approaches, and lack of self-blame. Women reported that changes in diet would be more achievable in the long term than changes in exercise patterns. Partners and the clinical team were significant sources of support. Women's views are crucial to providing clinicians with a comprehensive and holistic understanding of disease management. Involving women in self-care decisions and empowering women to manage their own health are key contributors to long-term behavior change as well as service provision and policy implementation [ABSTRACT FROM AUTHOR]

Poverty, lack of education and gender inequality make unemployed and out-of-school young women extremely vulnerable to HIV infection. Promotive social protection programmes aim to increase livelihood and capabilities and could empower this priority population to act on HIV prevention choices. In Botswana, they rarely benefit from such programmes. A modified Policy Delphi engaged a panel of 22 unemployed and out-of-school young women and eight frontline service providers to consider alternative policy and practice options, and tailor available programmes to their own needs and social situation. The panel assessed the desirability and feasibility of improvement proposals and, in a second round, ranked them for relative importance. Nearly all 40 improvement proposals were considered very desirable and definitely, or possibly, feasible, and panellists prioritised a wide range of proposals. Frontline service providers stressed foundational skills, like life skills and second chance education. Young women preferred options with more immediate benefits. Overall, panellists perceived positive role models for programme delivery, access to land and water, job skills training, and stipends as most important to empower HIV-vulnerable young women. Results suggest ample policy space to make existing social protection programmes in Botswana more inclusive of unemployed and out-of-school young women, hence more HIV-sensitive. [ABSTRACT FROM AUTHOR]

Indigenous adolescents in Canada are among those shouldering the impacts of colonialism and racism. Peer approaches and art-and-land-based programming have demonstrated promise to support empowerment and well-being, yet little is known about their efficacy with Northern and Indigenous adolescents in Canada or of how this group conceptualises empowerment. Fostering Open eXpression among Youth (FOXY) and Strength, Masculinities, and Sexual Health (SMASH) conduct land-and-arts-based Peer Leader Retreats with adolescents from the Northwest Territories, Nunavut and the Yukon Territories. Retreats (2017–2019) included 286 participants (n=196 women [trans-inclusive], n=84 men [trans-inclusive], n=5 non-binary), aged 12–19, the majority of whom (n=235) were Indigenous. Participants completed surveys immediately before and following retreats and 6 months after. Focus group discussions (FGDs) (n=24) were conducted with participants (peer leaders and apprentices) (n=232) following the retreat, and youth staff members (peer facilitators) (aged 14–21, n=7 FGDs). Applying thematic analysis, we explored retreat experiences (FGDs), and Wilcoxon signed-rank tests to examine pre/post retreat changes in leadership, empowerment, and self-confidence (surveys). Quantitatively, there were statistically significant increases in leadership and empowerment in post-retreat scores compared to preretreat. Qualitatively, findings demonstrate how Peer Leader Retreats premised on land-and-art-based approaches can support empowerment, confidence, leadership, and social-connectedness. [ABSTRACT FROM AUTHOR]

Femtech technologies, such as period and fertility trackers, promise their users empowerment through reliable knowledge about and control over their bodies and ownership of their procreative health. However, the notion of empowerment through period and fertility apps deserves scrutiny. Based on a thematic analysis of a range of 'female health' app promotion materials, we explore the kind of empowerment promised by app providers and point towards significant contradictions and tensions in the discursive tales of empowerment. Building on digital sociology and intersectional feminist scholarship, we observe that the discourse promoting many of the health apps is grounded in exclusionary ontologies, normative femininity, epistemic injustice and heterosexist notions of female sexuality, which undermines the liberational rhetoric of these digital health technologies. [ABSTRACT FROM AUTHOR]

This briefing explores the potentials of participatory video and new media (blogs) and their use to bring about social change on the example of women panchayat leaders in India who benefit to make their presence felt, be heard and seen. While the right to communicate is a basic human right, women in Bihar have always held secondary status in society and been marginalised. Their existence is reduced to family responsibilities, such as bearing children, cooking food and working on farmland. Yet, enough administrative structure is in place to ensure that women can access rights. Panchayats are one such system that aim to empower women by becoming public representatives. However, the system has been little effective due to lack of awareness and information about it. Thick administrative layers discourage transparency and accountability. This paper investigates how women panchayat leaders in Bihar use video and blogs to document facts, store them, process and reproduce them to make local politics transparent and accountable. [ABSTRACT FROM AUTHOR]

Community participation is a fundamental element of community radio and therefore one of its most important licence criteria. Many South African community radio stations are faith-based. However, existing research on community participation in such radio stations is based mainly on Christian stations, while the focus of this study is on a Muslim station. This article considers the participation of women at Radio Al-Ansaar in Durban, South Africa. It investigates how and to what extent community radio is used as a tool to advance the empowerment of Muslim sisters and examines the representation of women at board and operational level. It also questions if the radio station enables free participation among women across all portfolios, or if there exists a glass ceiling preventing women's participation. The paper outlines some of the successes, challenges and obstacles faced by the sisters of Al-Ansaar. [ABSTRACT FROM AUTHOR]

This profile focuses on the work of E-Knowledge for Women in Southern Africa (EKOWISA), a Zimbabwean non-governmental organisation that encourages communities to use Information Communication Technologies (ICTs) for livelihood development. The paper interrogates the assumption that ICTs empower women, the meaning of empowerment as well as the particular challenges to ICT access in rural areas (Marcelle, 2000) based on EKOWlSA's Community ICT project. [ABSTRACT FROM AUTHOR]

Purpose: In order for health professionals to encourage pregnant women with a low socioeconomic status (SES) to move towards empowerment for a healthy dietary intake, crucial steps are to understand the perspectives of pregnant women of food and eating and to identify opportunities for empowerment. This study aimed to examine the perspectives of pregnant women on food and eating and to identify the opportunities for empowerment towards a healthy dietary intake. Methods: This was a qualitative participatory study. Thirteen semi-structured interviews were conducted with low SES pregnant women in the Netherlands and analysed using an inductive approach. Results: Five perspectives on food and eating emerged: 1) health-promoting foods and products, 2) challenges in healthy eating, 3) risky products, 4) strategies for healthy eating, and 5) motivational aspects. Opportunities for empowerment were: searching balanced and personalized information, developing strategies to implement healthy diets, navigating the social environment, and dealing with different motivations. Conclusion: Pregnant women hold diverse perspectives regarding food and eating, signalling the need to adjust dietary support from health-care professionals. Professionals in antenatal care could optimize their interactions by engaging in pregnant women's empowerment processes to make healthy modifications to their dietary intake. [ABSTRACT FROM AUTHOR]

Contrary to the impression put forth in the literature, Spanish women at the turn of the twentieth century played an active and visible role in the business sphere. Using a unique database containing microdata on the founders of Spanish multi-owner firms from 1886 to 1936, this study analyses the role of female owners and the legal structures that supported their participation in business. In that 50-year period, over 10% of newly registered firms had at least one female owner. Of those owners, 70% were widows. The majority of those women had management responsibilities in their firm. Multi-owner firms with at least one female owner display marked differences, in terms of capital, number of partners, family ties, and management, from those run solely by men. [ABSTRACT FROM AUTHOR]

Peer violence is common globally, but a little researched topic in low-and middle-income countries. This study presents the evaluation of a two-year randomized controlled trial of a structured play-based life-skills intervention implemented in schools in Hyderabad, Pakistan. To determine the impact of the intervention on school-based peer violence (victimization and perpetration) and depression among school children. 40 single-sex public schools were randomized into two study arms (20 per arm 10 of each sex). A total of 1752 grade 6 students (929 from intervention and 823 from control schools) were enrolled in the trial. The two-year intervention was a biweekly structured game led by a coach followed by critical reflection and discussion for 30 minutes. Primary outcomes (exposure to peer violence exhibited through victimization and perpetration and depression) were evaluated using generalized linear-mixed models. Of the enrolled children (N = 1752) 91% provided data for analysis. There were significant decreases in self-reported peer violence victimization, perpetration and depression. For peer violence victimization, the reductions in the intervention and control arms were: 33.3% versus 27.8% for boys and 58.5% versus 21.3% for girls. For peer violence perpetration, the reductions were: 25.3% versus 11.1% for boys and 55.6% versus 27.6% for girls in the intervention and control arms, respectively. There were significant drops in mean depression scores (boys 7.2% versus 4.8% intervention and control and girls 9.5% versus 5.6% intervention and control). A well-designed and implemented play-based life-skills intervention delivered in public schools in Pakistan is able to effect a significant reduction in peer violence. [ABSTRACT FROM AUTHOR]

Background and Objectives: There is still no clear portrayal of women's empowerment in managing menopause. The present study was conducted to design a model for the empowerment of Iranian women in managing menopause. Materials and Methods: This qualitative study was conducted using the grounded theory on 40-60-year-old women who were first selected through purposive sampling and then by theoretical sampling from November 2013 to July 2016. Data were collected using 33 in-depth, semi-structured, individual interviews with 30 participants. Data were analyzed using the Strauss and Corbin(2008) approach and organized in MAXQDA-10. Results: The analysis of the data led to the emergence of "active coping with menopause" as the core variable with four themes. The two themes "threat to feminine identity" and "latent opportunity" explained the context of the study, and "redefining the feminine identity" and "self-retrieval" explained its process. Conclusion: In our social context, the phenomenon of menopause is a coin with two sides and its experience leans more on the threat to feminine identity and less on latent opportunity. The model of postmenopausal women's empowerment for managing menopause might offer health policy-makers a realistic and divergent understanding of the challenges of empowering women by explaining key concepts. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to examine what was beneficial and what was challenging in a group intervention for young adults based on RENEW principles in a municipal employment centre. RENEW (Rehabilitation for Empowerment, Natural support, Education, and Work) is an education-oriented support model for young people. Method: The eight young adults who participated in the group and three mentors who led the group were interviewed about their experiences with the group, and a workshop was held for staff to validate the themes found in the study. Results: Three themes emerged, one denoted the importance of helpful personal relationships, both between the mentors and the young adults and among the young adults; another denoted how an authentic attitude from the mentors made group exercises inconspicuous as the group members experienced activities in the group as originating from spontaneous, genuine interest rather than the manual-based exercises they were. The last theme conveyed how the group process was challenged by the institutionally regulated compulsory attendance and the mentors' lack of teamwork resources. Conclusions: The study suggests that meeting young adults authentically and flexibly combining a certain element of self-disclosure with a manual-based group intervention such as RENEW can strengthen relatedness and convey hope, thereby supporting educational rehabilitation. [ABSTRACT FROM AUTHOR]

Introduction: Multiple sclerosis (MS) treatment has changed considerably in recent years thanks to the introduction of ever-more-powerful drugs. Unfortunately, the higher efficacies of these therapies are associated with increased risks of severe adverse events. In this scenario, neurologists and persons with MS (pwMSs) must now balance benefits and risks when making decisions regarding MS management. Areas covered: This review highlights the importance of the risk perception of pwMSs and their neurologists in the shared decision-making process in MS management, taking into account different ways improve the empowerment and engagement of pwMSs. Expert commentary: The shared decision-making process in MS is strongly influenced by an individual’s risk perception, which is dynamic and influenced by the personal, emotional, social, and experiential factors of both the pwMSs and neurologists. [ABSTRACT FROM PUBLISHER]

This study aimed to investigate what it means to patients afflicted by a minor heart attack to participate in cardiac rehabilitation (CR). CR is well-established internationally to support patients towards moving forward in satisfying, healthy, and well-functioning lives. Studies indicate that patients achieve improvement in quality of life when participating in CR. However, knowledge of how patients are supported during CR is sparse. Moreover, knowledge of what participating in CR means to patients afflicted by a minor heart attack is lacking. In-depth knowledge in this area is crucial in order to understand these patients' particular gains and needs. In a phenomenological-hermeneutic frame field observations, focus group interviews, and individual interviews were conducted among 11 patients during and after their participation in CR. Field notes and transcribed interviews underwent three-phased interpretation. It was found that patients were supported to gain renewed balance in their lives during CR. Three themes were identified: (1) receiving a helpful but limited caring hand, (2) being supported to find new values in life, and (3) developing responsibility for the remaining time. The patients were carefully guided through a difficult time and supported to continue in healthy everyday lives. They were given hope which enabled them to find themselves a new foothold in life with respect to their own sense of well-being. This guidance and a sense of hopefulness were provided by heart specialists and more seasoned heart patients. In conclusion, patients were empowered to achieve a healthier lifestyle and improve their personal well-being during CR. However, structural barriers in the programme prevented adequate support regarding the patients' total needs. Knowledge of the benefits of CR emphasizes the significance of the programme and highlights the importance of high inclusion. Efforts should be made to develop more flexible and longer lasting programmes and further involvement of relatives must be considered. [ABSTRACT FROM AUTHOR]

A growing number of young people in Sweden with intellectual disability have organized themselves during the last 15 years in self-advocacy groups for socializing, empowerment, and expressing opposition to the norms and attitudes in a society that labels them as disabled. At the same time, the Swedish welfare system has transformed dramatically with processes of far-reaching individualization, closure of the major institutions, decentralization of responsibility from the state to local governments, and an emerging welfare market where service users are turned into customers. The aim of this article is to analyse and discuss the significance of self-advocacy in the new welfare context. Data were collected over a period of more than 10 years using repeated interviews with members of two self-advocacy groups and participation observations. Findings suggest that participation in self-advocacy groups opens up members for increasing health and well-being through new roles and identities, and it strengthens their control over everyday life. Support is still needed, however, but in new ways; otherwise, the restrictions of the institutions will simply be reconstructed in the new welfare system. [ABSTRACT FROM AUTHOR]

Background: Empowerment is essential for gender equity and health. The city of Malmö, Sweden, has formulated a development plan for gender equity integration (GEIDP). A 'Policy Empowerment Index' (PEI) was previously developed to assess the empowerment potential of policies. Objectives: To pilot-evaluate the GEIDP's potential for empowerment and to test the PEI for future policy evaluations. Design: The GEIDP was analyzed and scored according to electronically retrieved evidence on constituent opinion, participation, capacity development, evaluation-adaptation, and impact. Results: The plan's PEI score was 64% (CI: 48-78) and was classified as 'enabling', ranging between 'enabling' and 'supportive'. The plan's strengths were: 1) constituent knowledge and concern; 2) peripheral implementation; 3) protection of vulnerable groups; and 4) evaluation/adaptation procedures. It scored average on: 1) policy agenda setting; 2) planning; 3) provisions for education; 4) network formation; 5) resource mobilization. The weakest point was regarding promotion of employment and entrepreneurship. Conclusions: The PEI evaluation highlighted the plan's potential of constituency empowerment and proposed how it could be augmented. [ABSTRACT FROM AUTHOR]

Many unhealthy behaviors are created during adolescence and follow the individual into adulthood. In addition, health behaviors often occur in clusters as those who are inactive are more likely to eat unhealthy food and smoke. This makes the early foundation of healthy behaviors vital. The aim was to describe and develop an understanding of adolescents' awareness and experiences concerning health promotion. Data was collected using focus groups with a total of 28 seventh graders and was analysed with latent qualitative content analysis. One main theme was identified; being competent, ambivalent and creative at the same time. The following three subthemes also emerged: being a digital native for better and for worse, knowing what is healthy, and sometimes doing it, and considering change and having ideas of how change could be supported. The main theme elucidates how the majority of students were informed and able but they did not always prioritize their health. The concept of health promotion relies upon the engagement of the individual; however, although the students had clear ideas about how they would like to change their own behaviors, they felt a need for support. Interestingly, the students were able to make several suggestions about the kind of support that would make a difference to their adoption to more healthy modes of living. They suggested information and communication technology (ICT), for example encouraging text messages (SMS), and social support, for example parents setting rules and peers inspiring them to adhere to a healthy behavior. The knowledge gained from this study echoes our view of inclusion and this could be helpful for those who encounter the challenge of promoting health among adolescents. [ABSTRACT FROM AUTHOR]

Objectives: To describe the effects of a broad empowerment programme among female sex workers (FSWs) in Bangalore, India, which seeks to develop the capacities of these women to address the issues that threaten their lives and livelihoods. Design: This study is based on a comprehensive, on-going HIV-prevention and empowering programme, known as Pragati, which reaches out to approximately 10,00012,000 FSWs in Bangalore each year. The programme has been designed in collaboration with the sex worker community and provides a personalised set of services, which include STI prevention and treatment services, crisis-response facilities, de-addiction services, and microfinance support all of which have been tailored to adequately fulfil each woman’s needs. During the period examined by this study, the programme reached out to 20,330 individual FSWs [median (IQR) age 28 (2435) years]. The programme’s personal records of the participating FSWs were used for this descriptive study. Results: Between 2005 and 2010, the number of participating FSWs increased from 2,307 to 13,392. These women intensified their contact with the programme over time: the number of programme contacts increased from 10,351 in 2005 to 167,709 in 2010. Furthermore, data on the effects of crisis-response facilities, de-addiction and microfinance services, condom distribution schemes, and STI diagnosis and treatment showed an accumulating involvement of the participating FSWs in these programme services. Conclusion: This programme, which focuses on social and economic empowerment among FSWs, is successful in reaching and involving the target population. [ABSTRACT FROM AUTHOR]

Background: Policies that empower individuals and communities may be appropriate for public health, and more broadly. Simple, transparent and acceptable tools are therefore required to evaluate policies from an empowerment perspective. In 2008, the South African Department of Health (DOHSA) drafted a policy to endorse the integration of African Traditional Medicine (ATM) into the public health sector, following the World Health Organization's (WHO) long-standing directives.Objective: The purpose of this study is to critically analyze this policy using a novel evaluation tool. Design: A 12-point 'Policy Empowerment Index' (PEI) is introduced, and used to classify and score the policy according to five theoretical policy types. The evaluation was based on a stepwise review and associated publications: policy drafts, policy statements and news announcements. Results: According to the assessment tool, the ATM policy was marginally 'supportive' of constituent empowerment, although several 'directive' features were also observed. The importance of ATM to SA's communities and the promotion of education, employment, entrepreneurship and peripheral resource mobilization were the main empowering elements. Centralised conception, planning and implementation, the absence of provisions for local adaptations and the authoritative legislation context were sub-optimal features. Conclusions: South Africa's ATM legislation may need to further involve communities in policy design and implementation to capitalise upon the broader benefits of community empowerment. However, the iterative nature of method and evaluation is important. Indeed, they are proposed as points to initiate participatory development, and improve policy evaluation. Such instruments can empower constituents in the politicalprocess. [ABSTRACT FROM AUTHOR]

Greater 'empowerment' of women in India, measured by their education and autonomy, is associated with a reduction in the extent to which their sons' educational attainment exceeds that of their daughters. Improving both father's and mother's education increases the educational attainment of daughters more than that of sons, but raising mother's education is associated with a significantly greater reduction of the difference in attainment between sons and daughters. In families in which the mother has completed primary education, the average difference between boys and girls in years spent in school is almost a third of a year lower than it is where the mother has less education. A one-standard-deviation increase in mother's autonomy is associated with an increase in daughter's schooling of more than half a month but has no correlation with son's education. The findings highlight the importance of women's empowerment for the intergenerational transfer of equality in educational attainment of the sexes. [ABSTRACT FROM AUTHOR]

The extensive suffering related to a complex life situation with bipolar disorder (BD) and the reported difference between care needs and the needs that are actually met implicates that there are still questions about management of life with BD that need to be answered. The present study therefore aims to describe the meaning of the conditions that enable a good life with BD. Ten persons, six women and four men (aged 30-61), diagnosed with BD were interviewed. A reflective lifeworld perspective based on phenomenological philosophy was used. The findings present the essential meaning of the conditions that enable a good life with BD as a dependence that empowers, which is further described by its constituents: "turning the course of life," "protecting oneself from running out of energy," "being needed," "being oneself through reliable others," "personal landmarks for navigating through life." A voluntary chosen dependence, as described in the present study, is a new approach of care that enables a good life with BD, while enhancing own power, freedom, and control. The conditions that enable a good life with BD are more than separate supporting measures. Therefore a holistic perspective is preferable while providing care for individuals with BD. [ABSTRACT FROM AUTHOR]

Objectives. The aim was to analyse if young students could be substantive participants in a healthpromoting school project. The specific aims were to analyse the changes the students proposed in their school environment, how these changes were prioritized by a school health committee and to discuss the students' proposals and the changes from a health and gender perspective. Study design. An intervention project was carried out in an elementary school with students (about 150) in Grades 1 through 6. The intervention included small-group discussions about health promoting factors, following a health education model referred to as "It's your decision." At the last of 6 discussions, the students made suggestions for health-promoting changes in their school environment. A health committee was established with students and staff for the purpose of initiating changes based on the proposals. Methods. A content analysis was used to analyse the proposals and the protocols developed by the health committee. Results. The analysis showed 6 categories of the students' proposals: social climate, influence on schoolwork, structure and orderliness, security, physical environment and food for well-being. Their priorities corresponded to the students' categories, but had an additional category regarding health education. Conclusions. Principles that guide promoting good health in schools can be put into action among students as young as those in Grades 1 through 6. Future challenges include how to convey experiences and knowledge to other schools and how to evaluate if inequalities in health because of gender, class and ethnicity can be reduced through the focus on empowerment and participation. [ABSTRACT FROM AUTHOR]

Objectives. To review suicide patterns among Inuit in Canada and highlight new developments in Inuit-driven and community-based suicide prevention. Study design. Narrative overview of suicide among Inuit in Canada, strides towards Inuit autonomy, and community and government action towards suicide prevention. Methods. Review of Inuit meanings of mental health, movements towards Inuit control across Inuit Nunaat (the 4 Inuit regions) of Canada, and of community and government action towards suicide prevention. Results. Economic advancement is occurring in Inuit Nunaat following land claim settlements, and territorial and provincial governments are overseeing Inuit well-being. Inuit community engagement in suicide prevention is taking place and studies are being planned to evaluate the efficacy of such action for suicide prevention and community mental health. Initial evidence demonstrates that community control over suicide prevention itself can be effective towards preventing suicide. Conclusions. A new orientation is taking place in Canada in the name of Aboriginal community empowerment. There is a new hope for the model of meaningful community engagement and partnership with the Canadian government in suicide prevention and well-being. [ABSTRACT FROM AUTHOR]

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Emerging out of radical theories about the uneven nature of power and underwriting practices that assist marginalized peoples in constructing their own development strategies, “participation” has recently come under fire for being co-opted and mainstreamed by governmental and nongovernmental agencies, part of a new development “tyranny” that betrays the concept's populist roots. The issues surrounding participation are nowhere more hotly debated than in the area of conservation, where the requirements of ecological sustainability often collide with the demands of indigenous people seeking to control their own natural resources. As we show in this article, the issues become even more complex when the ideals and practices of participation circulating within a nongovernmental organization (NGO) are met by indigenous forms of empowerment, based not only on the resources of a remote and biologically diverse forest, but also on a pool of knowledge about development discourses themselves, including those of participation. Our case study examines interactions between an affiliate of the World Wildlife Fund operating out of Oaxaca, a state capital in southern Mexico, and a group of indigenous Zoque-speakers living in that state's Chimalapas forest. We interpret the collision between the NGO's “participation” and the Zoques' “empowerment” by employing “progressive contextualization,” an approach that leads us to identify and analyze the wider sets of conditions underpinning the encounter. We find that the Zoques invert a generic and aspatial politics of participation by insisting on a territorially-based, and thus intensely spatial, “politics of invitation” as they negotiate the complexities of participation within contemporary development. [ABSTRACT FROM AUTHOR]

Objective – To understand the experience of being at risk and of participating in health interventions. How is information about risk factors handled on an individual level with respect to feeling, thinking and doing? Design – Tape-recorded, open interviews, written out and analysed using a descriptive/analytical method. Setting – Selected women who had participated in a lifestyle intervention programme aimed at reducing risk factors for cardiovascular disease in Strömstad, a community of 10 000 inhabitants on the west coast of Sweden. Subjects – Eight women in the most active group who had had some contact with the project during the whole period 1985-94. Main outcome measures – The creation of core concepts as a result of close text reading through codes and categories. Results – Three core concepts in relation to the handling of risk factors were identified: there is no one but yourself to rely on, resisting invasion, and living with incompatibility, based respectively on the subjects' self-efficacy and self-awareness, their ways of maintaining a good life and their trying to understand the risk-factor concept. Conclusion – Risk-factor-oriented health interventions focus on disease and create uncertainty as to the relationship between the concepts of risk and disease. The powerful health resources demonstrated by the women in this study to counterbalance the risk pre-occupation suggest changing to health-oriented interventions that focus on individual health resources. [ABSTRACT FROM AUTHOR]

Purpose:This study aimed to describe adolescents' experiences of participating in a health-promoting school-based intervention regarding food and physical activity, with a focus on empowering aspects. Method: The school was located in a urban disadvantaged community in Sweden, characterized by poorer self-reported health and lower life expectancy than the municipality average. Focus group interviews with adolescents (29 girls, 20 boys, 14-15 years) and their teachers (n = 4) were conducted two years after intervention. Data were categorized using qualitative content analysis. Results: A theme was generated, intersecting with all the categories: Gaining control over one's health: deciding, trying, and practicing together, in new ways, using reflective tools. The adolescents appreciated influencing the components of the intervention and collaborating with peers in active learning activities such as practicing sports and preparing meals. They also reported acquiring new health information, that trying new activities was inspiring, and the use of pedometers and photo-food diaries helped them reflect on their health behaviours. The adolescents' experiences were also echoed by their teachers. Conclusions: To facilitate empowerment and stimulate learning, health-promotion interventions targeting adolescents could enable active learning activities in groups, by using visualizing tools to facilitate self-reflection, and allowing adolescents to influence intervention activities. [ABSTRACT FROM AUTHOR]

This study explores managers' perspective on how co-worker dialogue [CWD] can foster co-worker health and personal development, and contribute to an empowering development culture in the workplace. The interview study was performed at a hospital in Sweden. Seventeen hospital managers participated. The managers, both men and women, worked in different areas, and a majority had 30-40 co-workers. To uncover underlying pattern phenomena in the interview data, a six-step inductive qualitative thematic analysis was conducted. The findings present three themes, each highlighting different prerequisites for CWD to function as a resource for the co-workers and the workplace: (1) Utility; (2) Content, and (3) Implementation. The study provides suggestions for and problems of practical implications from the findings. To make the findings useful in other organizations, practical implications are presented and discussed in the light of workplace health promotion [WHP]. The CWD is not focusing on performance the way traditional PA does. The CWD is therefore an important complement to PA in annual co-worker meetings, to also highlight the co-worker perspective. If managers realize the value of working with both PA and CWD, opportunities for health, personal development, and an empowering development culture are created. [ABSTRACT FROM AUTHOR]

In the last couple of decades, the scaling up of successful pilot projects has been considered a crucial development strategy. The majority of scaling-up programs in developing countries stipulate the integration of gender as a central objective. In the article we argue that while the integration of gender in the scaling up of pilot projects has the potential to empower women, care should be taken not to overly focus on a segment of the women category (particular female heads of households) and overstate temporary gender gains that do not transform exploitative gender norms and practices. The article draws on evaluation research undertaken by researchers of the Scaling-up of Pulse Innovation for Food and Nutrition Security (SPIFoNS) Project, implemented in Southern Ethiopia. Data of this write-up were gathered using semi-structured questions, focus group discussions and observation. The article argues that if projects such as SPIFoNS are to adequately challenge patriarchy and contribute to bringing about gender equity, they need to recognize the heterogeneity of women and design multidimensional programs that can help married women to gain full access to resources and participate in important household decision-making processes. [ABSTRACT FROM PUBLISHER]