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In Stockholm (Sweden) a substantial number of persons who were infected with SARS-CoV-2 during spring 2020, and received intensive care followed by rehabilitation due to COVID-19, were of working age. For this group, return to work (RTW) is an important part of the rehabilitation, however this is an area that thus far has received little scholarly attention. The Aim of this study was two-fold. First, to descriptively look at self-reported work ability over time using the Work Abilty Index among working age adults who recovered from severe COVID-19, and secondly, to explore experiences and expectations concerning RTW among working age adults who recovered from severe COVID-19. Focus group interviews and qualitative thematic analyses were utilized. In addition, the study populations' self-reported work ability index was recorded over one year. Qualitative analysis of data resulted in 5 themes: a) Initial experiences after discharge from in-patient rehabilitation, b) Disparate first contact with work, c) Uncertainties about own role in RTW process, d) Working situation for those who had started getting back to work, and e) A need to reprioritize expectations for work in the context of everyday life. There were no statistical differences in work ability index scores between 18 and 52 weeks after discharge from an in-patient rehabilitation unit. RTW after COVID-19 can require systematic support for several months as well as be initiated earlier in the rehabilitation process. Further research in the area is needed.

Background Adolescence is a transition period in which positive experiences of physical activity have the potential to last into later adulthood. These experiences are influenced by socioeconomic determinants, leading to health inequalities. This study aims to explore adolescents’ experiences and participation in a multi-component school-based intervention in schools located in socioeconomically advantaged and disadvantaged areas in Sweden. Methods A qualitative design was used to evaluate how participants experienced the intervention. The intervention was a multi-component school-based intervention. It was conducted in six schools (four control and two intervention schools) with a total of 193 students and lasted one school year. It was teacher-led and consisted of three 60-minute group sessions per week: varied physical activities, homework support with activity breaks, and walks while listening to audiobooks. In total, 23 participant observations were conducted over eight months and 27 students participated in focus groups. A content analysis was conducted. Results The results describe a main category ‘Engaging in activities depending on socioeconomic status’ and three generic categories: 1. Variations in participation in PA together with classmates and teachers; 2. Variations in engagement in PA after school; and 3. Differences in time and place allocated to do homework and listen to audiobooks. These categories illustrate how participants looked forward to the physical activities but used the time spent during the walks and homework support differently depending on how busy they were after school. Frequently, those who were busiest after school were also those from the advantaged area, and those who had little to do after school were from the disadvantaged area. Conclusion Socioeconomic factors influence participants’ possibilities to engage in the intervention activities as well as how they use their time in the activities. This study showed that it is crucial to support adolescents’ participation in physical activities by providing structure and engaging well-known teachers in the activities, especially in schools located in disadvantaged areas.

Background Current evidence suggests that even in high-income countries such as Sweden, there are socioeconomic differences in children’s participation in physical activity. While family-based programmes appear promising to encourage physical activity, there is a lack of knowledge on how to engage families in such programmes, particularly in socioeconomically disadvantaged areas. The Open Health-Promoting Activities programme was launched to promote physical activity outdoors and health equity for children and their families in these areas. This study aims to explore parents’ experiences with the Open Health-Promoting Activities programme in socioeconomically disadvantaged areas, focusing on family engagement in physical activity and perceived changes in family dynamics. Methods A qualitative design with an ethnographic approach was employed. In line with an ethnographic approach, the research team conducted 15 participant observations of the programme sessions on Saturdays during Spring 2022. Field notes were compiled during the observations, which provided contextual information for individual interviews with 12 programme participants. These interviews were conducted after the researchers attended the programme. The participants were adults/parents who participated in the programme with one or more of their children. An inductive reflexive thematic analysis was used to analyse the field notes and interviews. Results The analysis identified three main themes: (1) prioritising children’s equal engagement in physical activity, (2) helping parents promote children’s healthy lifestyles, and (3) improving family dynamics through engagement in physical activity. Each theme captures an aspect of the programme that parents perceived as essential to facilitating their family’s engagement in the programme. All the themes are interconnected and form the basis for improving family dynamics. Conclusion To develop tailored family-based programmes in socioeconomically deprived communities, it is crucial to understand parents’ experiences and perceptions of aspects that facilitate their children’s engagement in physical activity. The findings suggest that emphasising equal opportunities, a safe space approach and participation are essential for increasing family engagement in physical activity. These elements also supported increasing parents’ awareness of their children’s need to be active and have fun together.

Introduction and aim Ethnically diverse neighborhoods encounter pronounced inequalities, including housing segregation and limited access to safe outdoor spaces. Residents of these neighborhoods face challenges related to physical inactivity, including sedentary lifestyles and obesity in adults and children. One approach to tackling health inequalities is through family-based programs tailored specifically to these neighborhoods. This study aimed to investigate parents’ experiences and perceptions of the family-based Open Activities, a cost-free and drop-in program offered in ethnically diverse and low socioeconomic neighborhoods in Sweden. Methods Researchers’ engagement in 15 sessions of the Open Activities family-based program during the spring of 2022, and individual interviews with 12 participants were held. Data were analyzed using reflexive thematic analysis. Results The analysis resulted in three main themes and seven sub-themes representing different aspects of the program’s meaning to the participants as parents, their families, and communities. The main themes describe how parents feel valued by the program, which actively welcomes and accommodates families, regardless of cultural differences within these neighborhoods. The themes also show how cultural norms perceived as barriers to participation in physical activity can be overcome, especially by mothers who express a desire to break these norms and support girls’ physical activity. Additionally, the themes highlight the importance of parents fostering safety in the area and creating a positive social network for their children to help them resist criminal gang-related influences. Conclusions The program’s activities allowed parents to connect with their children and other families in their community, and (re)discover physical activity by promoting a sense of community and safety. Implications for practice include developing culturally sensitive activities that are accessible to and take place in public spaces for ethnically diverse groups, including health coordinators that can facilitate communication between groups. To enhance the impact of this program, it is recommended that the public sector support the creation of cost-free and drop-in activities for families who are difficult to reach in order to increase their participation in physical activity, outreach, and safety initiatives.

Scholars within critical qualitative inquiry and health sciences are becoming increasingly interested in transformative scholarship as a means to pursue greater justice in society. However, transformative scholarship has been taken up within frameworks that given a lack of consistent alignment with the critical paradigm seem to fall short in this intention. This article aims to reclaim transformative scholarship as an epistemological and methodological space that transforms and challenges the social order, situating social justice at the forefront of inquiry. The article begins by addressing the call for work toward social justice within critical qualitative inquiry. Subsequently, Creswell and Mertens’ frameworks are analyzed as examples of transformative scholarship that has distanced itself from its critical roots. Based on this analysis, we raise three problematics to illustrate the dangers of this distancing. We conclude by proposing to reframe transformative scholarship within the critical paradigm to (re)connect it to political stances and values.

Several international agencies have called health professionals, including occupational therapists, to address the social determinants that create and sustain health inequalities within marginalized communities (European Public Health Association, 2020; Paris, 2017; World Health Organization, 2012, 2003). Occupational therapy population-based health promotion services have the potential to contribute to public health national and international goals such as the Sustainable Development Goals [SDG] (e.g., SDG3: Ensure healthy lives and promote well-being for all at all ages), those outlined in Healthy People 2030 by the United States Government, and Health 2020 by the WHO/Europe. [...]issues of occupational injustices and justice have been identified as fundamental issues for the occupational therapy profession (Hocking, 2017; Kinsella & Durocher, 2016; World Federation of Occupational Therapists, 2019). According to Harrison & Graham (2012), the first step to support the implementation of programs is through inquiry that focuses on local context in a problem-focused and context-driven approach.

The care of older persons is facing several challenges, especially as care tasks are becoming increasingly rationalized with less opportunity for relational engagement between nurse assistants and older persons. Evidence suggests this engagement is needed to promote well-being and satisfaction among the older persons with whom they work. The aim of this study was to explore how care, in the context of worker perspectives, is understood and experienced in home or residential care facilities. Focus-group interviews were conducted with experienced nursing assistants (n = 14) working in urban municipalities in Sweden. Data were analyzed using reflexive thematic analysis. The main theme: \"This work is more than a checklist of tasks, it's like simultaneous mind puzzles\", exposes the shortcomings of a \"task and time\" oriented care system while expecting individualized relational care practices. Three subthemes emerged: \"It's about responsibility, not remuneration\", \"Knowing them is part of the job\" and \"We do a lot that is not our job\". Participants expressed working responsibly day-to-day to find solutions to meet the needs of older persons. Tensions experienced between task and relational care orientations align to variation in understandings of care. These subthemes highlight that their work requires being context-sensitive to adapt in the moment, much like trying to solve mind puzzles. Increased rationalization of care, while expecting focus on relational aspects, sets nursing assistants in a challenging position. This paradox negatively affects the health of nursing assistants by creating unsustainable work. Without recognition of the required cognitive engagement in problem solving that is part of their work, the challenges of retention, sick leave and burnout are unlikely to be addressed. To ensure coordinated continuative care for older persons, nursing assistants need time and agency to enact relational practices that facilitate doing their work's dynamic care puzzles.

Most of the risk factors for stroke are modifiable, yet incorporating and sustaining healthy lifestyle habits in daily life that reduce these risk factors is a major challenge. Engaging everyday activities (EEAs) are meaningful activities that are regularly performed that have the potential to contribute to the sustainability of healthy lifestyle habits and reduce risk factors for stroke. The aims of this study were (1) to investigate the feasibility and acceptability of a digitally supported lifestyle program called “Make My Day” (MMD) for people at risk for stroke following a transient ischemic attack, and (2) to describe participants’ stroke risk and lifestyle habits pre- and post-intervention. A multiple case study design using mixed methods was utilized (n = 6). Qualitative and self-reported quantitative data were gathered at baseline, post-intervention, and 12 months post-baseline. The results indicate that MMD can support lifestyle change and self-management for persons at risk for stroke following a TIA. The findings indicate a high acceptability and usability of MMD, as well as a demand for digital support provided via a mobile phone application. Self-management with digital support has the potential to increase participation in EEAs for persons at risk for stroke following a TIA.

Sharp increases in \"child migrants\" from Central America detained at the US border in 2014 brought unprecedented levels of attention to long extant social and political issues perceived as causing youth migration. While governments on both sides of the US border faced criticism over responses to the migration \"crisis,\" the presumed causes of this migration presented in US media discourses went largely unquestioned. This article presents data collected in June 2015 from in-depth interviews with Guatemalan and transnational non-governmental organization (NGO) staff, scholars, lawyers, and activists in order to understand the complex interpretations of child migration by NGO actors in Guatemala. Findings illustrate how NGOs may selectively draw on the power of prevailing media narratives to buttress ideological and programmatic goals while simultaneously contesting how the same media depictions obscure the lived realities of migrants. We consider the transnational information politics of representations of \"child migration\" across government, media, and civil society sectors and the critical role of NGOs in articulating the complex realities faced by populations vulnerable to migration. La forte hausse du nombre « d'enfants migrants » d'Amérique centrale détenus à la frontière américaine en 2014 a attiré une attention sans précédent sur la longue liste des enjeux sociaux et politiques perçus comme responsables du problème. Tandis que les gouvernements des deux côtés de la frontière ont été critiqués pour leur réponse à la « crise » de la migration, les causes présumées de cette dernière présentées dans les médias américains ont été que peu souvent mises en doute. Cet article présente des données recueillies en juin 2015 dans le cadre d'entrevues détaillées menées auprès de personnel, académiques, avocats et activistes du Guatemala et d'organisation non gouvernementale (ONG) transnationale pour comprendre les complexités des interprétations de la migration des enfants en dehors du discours américain dominant. Les résultats illustrent comment les ONG peuvent délibérément profiter des exposés médiatiques qui prévalent pour fortifier leurs objectifs idéologiques et de programmation, tout en contestant la façon dont les mêmes comptes-rendus des médias ternissent la réalité vécue des migrants. Nous avons pris en considération les politiques d'information transnationale relatives aux représentations de la « migration des enfants » des secteurs gouvernemental, médiatique et de la société civile, et du rôle critique des ONG dans l'articulation des réalités complexes auxquelles les populations menacées par la migration font face. Der starke Anstieg in der Zahl der „Migrantenkinder“ aus Zentralamerika, die 2014 an der U.S.-amerikanischen Grenze in Gewahrsam genommen wurden, lenkte eine bis dato nicht gekannte Aufmerksamkeit auf schon lange bestehende soziale und politische Probleme, die als Ursache für die Jugendmigration angesehen werden. Während die Regierungen auf beiden Seiten der U.S.- Grenze für Ihren Umgang mit der „Migrationskrise“ kritisiert wurden, wurden die in den U.S.-Medien dargestellten vermeintlichen Gründe für die Migration kaum hinterfragt. Dieser Beitrag präsentiert Daten, die im Juni 2015 im Rahmen ausführlicher Interviews mit Mitarbeitern guatemaltekischer und transnationaler Nichtregierungsorganisationen (NROs), Wissenschaftlern, Rechtsanwälten und Aktivisten erfasst wurden, um die Auslegungsschwierigkeiten hinsichtlich der Kindermigration außerhalb dominanter Diskurse in den USA zu verstehen. Die Ergebnisse zeigen, wie NROs unter Umständen selektiv die Macht vorherrschender Mediendarstellungen heranziehen, um ideologische und programmatische Ziele zu untermauern, doch gleichzeitig beanstanden, wie diese Mediendarstellungen die Lebensrealitäten von Migranten verschleiern. Wir betrachten die transnationale Informationspolitik zur Repräsentation der „Kindermigration“ in Regierungen, Medien und Bürgergesellschaften und gehen auf die kritische Rolle der NROs ein, die komplexen Realitäten migrationsgefährdeter Bevölkerungsgruppen zu formulieren. Los fuertes aumentos de \"niños migrantes\" de América Central detenidos en la frontera de Estados Unidos en 2014 atrajeron niveles de atención sin precedentes sobre los problemas políticos y sociales existentes desde hace tiempo percibidos como los causantes de la migración juvenil. Aunque los gobiernos a ambos lados de la frontera estadounidense se enfrentaron a críticas sobre las respuestas a la crisis de \"migración\", las presuntas causas de esta migración presentadas en los discursos de los medios de comunicación estadounidenses no fueron cuestionadas en gran parte. El presente artículo presenta datos recopilados en junio de 2015 de entrevistas en profundidad con personal de organizaciones no gubernamentales transnacionales y guatemaltecas (NGO), académicos, abogados y activistas con el fin de comprender las complejidades de las interpretaciones de la migración juvenil fuera de los discursos estadounidenses dominantes. Los hallazgos ilustran cómo las NGO pueden recurrir selectivamente al poder de los discursos de los medios de comunicación predominantes para respaldar metas ideológicas y programáticas cuestionando simultáneamente cómo las descripciones de dichos medios de comunicación oscurecen las realidades vividas de los migrantes. Consideramos las políticas de información transnacionales de las representaciones de la \"migración juvenil\" en el gobierno, en los medios de comunicación y en los sectores de la sociedad civil y el papel crítico de las NGO en la articulación de las complejas realidades a las que se enfrentan las poblaciones vulnerables a la migración.

Widespread appeals to advance a social justice agenda have emerged within health-related fields. However, expressing a commitment to social justice has created tensions within occupational science and therapy as scholars attempt to enact social transformative scholarship while at the same time having roots within health sciences, a field largely dominated by positivist/postpositivist thinking. The broader intent of this thesis is to inform further development of occupation-based social transformative scholarship aligned with the critical paradigm. This doctoral dissertation is comprised of five integrated manuscripts, in addition to introduction and discussion chapters. Chapter two examines the increasing use of critical perspectives and outlines the ways in which these perspectives have challenged the assumptions underlying occupation. Chapter three introduces critical reflexivity and critical epistemology, illustrating their importance in examining the beliefs guiding occupation-based work that attempt to promote occupational justice. Chapter four introduces transformative scholarship and raises three problematics to illustrate the dangers of relying on positivist/postpositivist assumptions in frameworks promoting social transformation. Chapter five presents a critical dialogical approach as one way forward in expanding research that can inform social transformation by incorporating dialogue and examination of taken-for-granted understandings that shape practice. Chapter six examines the experiences of individuals attempting to enact occupation-based social transformative practices by using a critical dialogical approach. A critical discourse analysis that deconstructs and situates participants’ experiences within larger discourses is presented. The findings illustrate how discourses and contextual forces create tensions for social transformative practices, and how individuals negotiate and/or resist these tensions. Chapter seven highlights the implications of this thesis for occupational science and therapy, other professions, and critical qualitative inquiry. This thesis contributes to the ongoing discussions about the theoretical underpinnings and approaches that occupational science and therapy need to embrace to move forward in critically-informed and socially responsive ways. It adds to this body of knowledge through illustrating how knowledge and practice are shaped by broader forces that can frame attempts to enact transformative work in ways that obscure the structural causes of inequities. Additionally, it contributes to epistemological and methodological discussions that seek to develop appropriate ways to move in transformative directions.