Health promoting and empowerment enabling environments
Promoting health is a crucial goal in Finnish health policy. This research projact aims to strengthen research in the area of health promotion, and focuses on the influence of the environment on health and health behaviour, with a special emphasis on social, cultural and empowerment-enabling factors. Population groups in focus are adolescents, people with type 2 diabetes and older adults, and the corresponding contexts are schools, families and communities; primary healthcare and municipalities; and the Nordic countries. The research project includes three main studies: 1. Health and health behaviour trends and differentials among students in Swedish and Finnish speaking schools in Finland, 2. The Good Diabetes Care – research project, and 3. Health promotion in a Nordic perspective.
Health and health behaviour trends and differentials among students in Swedish and Finnish speaking schools in Finland
Health is a resource for children and adolescents in everyday life, and circumstances during this period of life can have a huge impact on the health development further on. Knowledge about health, wellbeing and health behaviour as well as influencing factors and changes over time is needed to support decision-making and health promotion work at different societal levels.
In the study, we explore perceived health, health behaviours and social contexts among 11-, 13- and 15-year old students – and changes in these during the last two decades – as well as among upper secondary students and students in vocational schools, in a new study that started in 2020. Factors influencing health and health differences, in particular empowerment-enabling factors, including health literacy, are investigated. Moreover, we explore possible differences in these indicators and trends between students in Swedish and Finnish speaking schools, in order to generally understand health development better. We use data from 1. the Finnish sample of school children of the international multi-center study ’Health Behaviour of School-aged Children’ (HBSC http://www.hbsc.org/), coordinated by the World Health Organization WHO and University of Jyväskylä (in Finland), and 2. the study Physical Activity Behaviours of Children and Adolescents in Finland (LIITU-study) coordinated by University of Jyväskylä. Both studies collect nationally representative data, and are done in cooperation with FHRC, and thus data also from Swedish-speaking schools in Finland is ensured.
The Good Diabetes Care – research project
Rising prevalence of type 2 diabetes (T2D), also among younger adults, is an increasing public health challenge in Finland and worldwide, which also puts growing pressure on health systems. The ‘Good Diabetes Care’ research project focuses on the effectiveness of diabetes care. The aim is to find the best possible means by which primary healthcare and municipalities can achieve favourable outcomes in diabetes care. The sample was drawn from a nationwide register, and nearly 2 900 adults with T2D, in five municipalities in Finland, participated in the postal mail survey in 2011, yielding a 57% response rate.
The research project investigates:
1) quality of care in primary healthcare, with a focus on how person-centred coordinated care (congruent with the Chronic Care Model), continuity of care, autonomy supportive healthcare climate, and trust in health care personnel are associated with outcomes of care, such as, diabetes self-management incl. healthy lifestyles, empowerment and health outcomes, and
2) which other important life-contextual factors, such as, age, life-stress, diabetes-related distress, chronic pain, emotional wellbeing and social support, also community support incl. possibility to influence health and life-quality issues in the community, are associated with outcomes of care among patients with type 2 diabetes.
Health promotion in a Nordic perspective
The Nordic countries are known for their extensive welfare regimes, good living conditions and relatively good public health. Research comparing and contrasting health promotion strategies, contexts and outcomes with a Nordic perspective is one way to strengthen the knowledgebase and also develop the theoretical understanding of health promotion. This study is part of a collaboration within the Nordic Health Promotion Research Network (NHPRN), having a special focus on healthy ageing. However, also other point of views are explored.
Healthy ageing in a Nordic perspective
Ageing linked to health is an important issue when the older population increases. Healthy Ageing has been defined as the process of optimizing opportunities for physical, social and mental health to enable older people to take an active part in society without discrimination and to enjoy an independent and good quality of life.
With the definition above as a point of departure, the study applies theory and perspectives from the humanities and social sciences in order to understand the impact of specific contexts in which people age. The Nordic welfare states and their ongoing changes are an important background for the study. The research applies primarily qualitative methods, recognizing the importance of the voices of the older persons, with an empirical focus on interviews, narratives and text analysis. Central concepts and values explored empirically and theoretically are dignity, autonomy, participation and a sense of security. This study is a collaboration within the ‘Healthy Ageing’ group, as part of the NHPRN.
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Health and Health behaviour trends
Nina Simonsen, PhD, PI (HBSC- and LIITU-study)
Carola Ray, Adjunct Professor, PhD (LIITU-study)
Jasmine Gustafsson, MSc, Doctoral student, Visiting Researcher (HBSC-study)
The Good Diabetes Care research project
PI Nina Simonsen, PhD, PI
Health promotion in a Nordic perspective
PI Nina Simonsen, PhD, PI
Health and Health behaviour trends
Simonsen N, Wackström N, Roos E, Suominen S, Välimaa R, Tynjälä J, Paakkari L. Does health literacy explain regional health disparities among adolescents in Finland. Health Promotion International 2021, 1-12doi: 10.1093/heapro/daaa122
Gustafsson J, Lyyra N, Välimäki R, Simonsen N. Socialt stöd, känsla av ensamhet och psykiska besvär bland finlandssvenska ungdomar (Social support, loneliness, and psychological complaints among Finnish-Swedish adolescents). Sosiaalilääketieteellinen Aikakauslehti 2021; 58:128-142
Hanna Paasio, Leena Martin, Riikka Hämylä, Sami Kokko, Eva Roos and Nina Simonsen. Suomen- ja ruotsinkielisten erot liikuntakäyttäytymisessä. In Kokko S, Hämylä R, Martin L. (eds.) Lasten ja nuorten liikuntakäyttäytyminen Suomessa. LIITU-tutkimuksen tuloksia 2020. Valtion liikuntaneuvoston julkaisuja 2021:1. Helsinki, 104-110. https://www.liikuntaneuvosto.fi/wp-content/uploads/2021/05/Nuorten-liikuntakayttaytyminen-Suomessa-LIITU-tutkimuksen-tuloksia-2020.pdf
Simonsen N, Lahti A, Suominen S, Välimaa R, Tynjälä J, Roos E, Kannas L. Empowerment-enabling home and school environments and self-rated health among Finnish adolescents. Health Promotion International 2020;35(1):82-92; doi:10.1093/heapro/day104. (advance access 24 December 2018)
Simonsen N, Roos E, Suominen S, Laakso M, Lehto E, Villberg J, Tynjälä J, Välimaa R, Ojala K, Kannas L: Hälsotrender bland elever i svensk- och finskspråkiga grundskolor 1994–2014: WHO:s skolelevsstudie (HBSC-Study). Research Center for Health Promotion, University of Jyväskylä, Publications 7, 2016. https://jyx.jyu.fi/handle/123456789/51712
Nuutinen T, Lehto E, Ray C, Roos E, Villberg J, Tynjälä J: Clustering of energy balance-related behaviours, sleep, and overweight among Finnish adolescents. International Journal of Public Health. 2017;62(8):929-938. DOI: 10.1007/s00038-017-0991-4
Hagquist C, Välimaa R, Simonsen N, Suominen S. Differential Item Functioning in Trend Analyses of Adolescent Mental Health – Illustrative Examples Using HBSC-Data from Finland. Child Indicators Research 2016:1-19.
Jenny Ray, Eva Roos & Leena Martin. Barn och ungdomars motions- och idrottsvanor i Finland.
Resultat från LIITU-studien 2018: Rapport for Åland. Ålands landskapsregering 2019. https://www.utbildning.ax/sites/default/files/media/liitu-rapporten.pdf
Pauliina Hiltunen, Eva Roos ja Leena Martin: Suomen- ja ruotsinkielisten erot liikuntakäyttäytymisessä. In: Kokko S, Martin L, eds. Lasten ja nuorten liikuntakäyttäytyminen Suomessa: LIITU-tutkimuksen tuloksia 2018 (pp 117-125). Hki: Valtion liikuntaneuvoston julkaisuja 1, 2019. https://www.jyu.fi/sport/vln_liitu-raportti_web_28012019-1.pdf
Eva Roos, Anette Mehtälä, Carola Ray, Sami Kokko, Sofia Hampf: Suomen- ja ruotsinkielisten erot liikuntakäyttäytymisessä. In: Sami Kokko, Anette Mehtälä eds. Lasten ja nuorten liikuntakäyttäytminen Suomessa - Liitu-tutkimuksen tuloksia 2016 (pp 67-72). Valtion liikuntaneuvoston julkaisuja 12, 2016. https://www.liikuntaneuvosto.fi/wp-content/uploads/2019/09/LIITU_2016.pdf
The Good Diabetes Care research project
Simonsen N, Koponen AM, Suominen S. Empowerment among adult patients with type 2 diabetes: age differentials in relation to person-centred primary care, community resources, social support and other life-contextual circumstances. BMC Public Health 2021; 21:844. doi.org/10.1186/s12889-021-10855-0
Wackström N, Koponen AM, Suominen S, Tarkka I, Simonsen N. Does chronic pain hinder physical activity among older people with type 2 diabetes? Health Psychology and Behavioral Medicine 2020 8:1, 362-382, DOI: 10.1080/21642850.2020.1807350
Koponen A. M., Simonsen N., Suominen S. How to promote fruits, vegetables, and berries intake among patients with type 2 diabetes in primary care? A self-determination theory perspective. Health Psychology Open, 2019; 6(1), 2055102919854977-2055102919854977.
Simonsen N, Koponen AM, Suominen S. Patients' assessment of chronic illness care: a validation study among patients with type 2 diabetes in Finland. BMC Health Services Research. 2018; 18:412. doi:10.1186/s12913-018-3206-7.
Koponen AM, Simonsen N, Suominen SB. Success in increasing physical activity (PA) among patients with type 2 diabetes: a self-determination theory perspective, Health Psychology and Behavioral Medicine. 2018; 6:1, 104-119, DOI: 10.1080/21642850.2018.1462707
Koponen AM, Simonsen N, Suominen SB. Success in Weight Management Among Patients with Type 2 Diabetes: Do Perceived Autonomy Support, Autonomous Motivation, and Self-Care Competence Play a Role? Behavioral Medicine. 2017; doi:10.1080/08964289.2017.1292997.
Koponen AM, Simonsen N, Suominen S. Quality of primary health care and autonomous motivation for effective diabetes self-management among patients with type 2 diabetes. Health Psychology Open. 2017; doi:10.1177/2055102917707181.
Koponen AM, Simonsen N, Suominen S. Determinants of physical activity among patients with type 2 diabetes: the role of perceived autonomy support, autonomous motivation and self-care competence. Psychol. Health Med 2016:1-13.
Koponen AM, Simonsen N, Laamanen R, Suominen S. Health-care climate, perceived self-care competence, and glycemic control among patients with type 2 diabetes in primary care. Health Psychology Open 2015:2.
Health promotion in a Nordic perspective – healthy ageing
Clancy A, Simonsen N, Lind J, Liveng A, Johannessen A. The meaning of dignity for older adults in a Nordic context: A meta-synthesis. Nursing Ethics. Online first July 2020 doi.org/10.1177/0969733020928134
Mahler M, Clancy A, Johannessen A, Lind J, Liveng A, Sarvimäki A, Stenbock-Hult B, Simonsen N. Nordiske sundhedsfremmende perspektiver på ældre menneskers deltagelse og tryghed. Nordisk Tidsskrift for Helseforskning 2020;16 (1) doi:10.7557/14.5176.
Lahti A-M, Simonsen N, Seppänen M, Finne M, Sarvimäki A & von Bonsdorff MB. Folkhälsans seniorboende och aktivt åldrande: BoAktiv-studien. Gerontologia 2019, vol. 33 , nr. 2 , s. 74-85.
Mahler M, Sarvimäki A, Clancy A, Stenbock-Hult B, Simonsen N, Liveng A, Zidén L, Johannessen A, Hörder H. Home as a health promotion setting for older adults. Scandinavian Journal of Public Health 2014:42:36-40.
Health and Health behaviour trends:
Jorma Tynjälä, Raili Välimaa, Nelli Lyyra, Leena Paakkari, Sami Kokko: University of Jyväskylä, Department of Health Sciences
The Good Diabetes Care research project:
Prof. Sakari Suominen, University of Turku, Department of Public Health; University of Skövde
Health promotion in a Nordic perspective:
Collaboration within the Nordic Health Promotion Research Network
Samfundet Folkhälsan
The Swedish Cultural Foundation in Finland
Government of Åland
The Social Insurance Institution of Finland
Medicinska understödsföreningen Liv och Hälsa
The Finnish Cultural Foundation, Varsinais-Suomi Regional Fund
University of Helsinki, Department of Public Health
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Nina Simonsen
PhD, Scientist
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