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Towards Roma Empowerment and Social Inclusion Through Work-Integrated Learning
University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The Roma people are the largest ethnic minority group in the EU and all over, they have been subject to prejudice, stigma, discrimination and oppression. Thus, Roma are the most economically and socially excluded and marginalized group in Europe. The Roma living in Sweden are no exception; many are on the margins of society and face problems of social exclusion, institutional discrimination, low education, unemployment, and poor objective health. The Roma have been treated as a helpless group in need of "expert" help and action from the authorities. They have usually not been permitted to actively participate in adjusting efforts to their needs and situation. An alternative approach to the Roma situation is to allow the Roma to take the leading role and to initiate processes and activities concerning the group.These were the foundations for the 3-year health promotion project based on participatory action research (PAR) initiated in West Sweden in 2009. Through work-integrated learning(WIL) and the principle of training the trainers, the purpose of the programme was to strengthen Roma empowerment and participation in society, enabling Roma-led integration.The overall aim of the PhD thesis was to analyse and elaborate a WIL model to be applied inempowerment and adult education for the Roma minority- and other vulnerable groups in similar situation. The thesis is based on five papers: Paper 1 aimed to examine how 14 Roma adolescents in West Sweden perceive the concepts of health, well-being and quality of life, and further, to investigate the degree to which theyconsider themselves able to cope with their own life situation within these areas. The data, comprising six interviews, was analysed through qualitative content analysis. The most common understanding of health and well-being was to feel good, secure, happy and having awide social network of family and friends. Health and well-being were considered in a collective perspective, thus controversy earlier studies, the respondents perceived their health and well-being to be good. Freedom, independency, education and employment were the most important elements of QoL. Social support was the most frequently used coping strategy.

The Roma adolescents preferred the tight relationship within the Roma community and associated mostly with Roma, a phenomenon previously referred to as homophily. The processof homophily seemed to be a salutogenic factor and a general resistant resource of the Roma adolescents and hence health-enhancing. Homophily was suggested as a determinant factor of health.Paper 2 aimed to explore how Roma people in West Sweden understand health, well-being,and quality of life, and how they cope with their life-situation. The data, consisting of 27 interviews (n = 33), were analysed qualitatively using a phenomenological hermeneutic approach. The findings indicated that the respondents perceived health as a resource and an ability to self-manage. Crucial elements of the respondents' health perception were being employed, having an education, social support from family and friends, freedom and security,and involvement in society. The findings demonstrated that the respondents perceived their health and life situation as good, despite being marginalized and discriminated. A possible explanation to this is what the respondents described as survival strategies. As a result of decenniums of oppression, the Roma have developed survival strategies helping them to cope with the situation and to survive. Paper 3 aimed to analyse whether there is connection between health literacy and empowerment. The paper is based on a literature search conducted in December 2013. Of the total 303 initial hits, no articles primarily addressing the issue were found; yet five articles were identified taking up on both health literacy and empowerment, hence reviewed in more detail. The five articles acknowledged a nexus between health literacy and empowerment, though the nexus itself was never discussed in specific. The paper suggests that for health literacy to be critical to empowerment, the focus has to be on social determinants of health and the involved individuals', groups and/or communities perceptions on health and health needs defined by themselves. Such a perspective will build on the genuine needs of the people in concern. The paper proposes functional- and interactive health literacy as another way to label capacity building for health and empowerment, and critical health literacy as a way to describe empowerment. Hence, health literacy might be regarded as a tool for empowerment. Health literacy is considered not to automatically lead to empowerment. Health literacy as such might be increased by health education. Crucial for empowerment is to achieve the critical level of health literacy including an ability to question the prevailing power relations and societal conditions and reflecting on these, a strengthened sense of power, self-esteem and self efficacyand an ability to utilize these resources to engage in social and political action for change.Paper 4 aimed to explore how participatory action research (PAR) and work integrated learning (WIL) might function as empowering tools in the Roma inclusion process and to propose a working model to use in empowerment of the Roma minority- and other vulnerable groups in similar situation. The data were collected and produced continuously during the project and consisted of interviews, self-evaluation reports and written essays by the seven Roma participants, participatory observations, research groups' workshop notes, 21 monthly project reports, the project plan, syllabus of the WIL training programme and notes from ajoint planning workshop. The data were considered as a whole and analysed in a triangulating fashion using hermeneutical understanding inspired by heuristic research. Through improved abilities to mobilise the local Roma community for social change, the participants' critical health literacy improved, allowing them to experience a greater control over their own lives and integration processes. The results indicate an increased empowerment of the local coordinators indicating that WIL may be a worthwhile approach in strengthening the individual empowerment of Roma people. Based on the findings, health literacy was suggested as a catalyst in the empowerment process, serving as a tool for analyzing and describing the process of empowerment.Paper 5 aimed to analyse the health promotion project from the Roma participants' perspective. The focus was on the participants' perceived individual empowerment and perceptions on their contribution to the common good and community empowerment. The data, consisting of interviews and self-evaluation reports of the Roma participants,participatory observations, newspaper articles with interviews of the participants and 21 monthly reports, were analysed through an approach that comes closest to hermeneutical phenomenology. The findings indicate that the WIL approach, the participating nature of the programme, and the trust and support from both the Roma and the non-Roma facilitators, were essential for the development of empowerment. Three main themes emerged portraying the participants' psychological empowerment: strengthened Roma identity, sense of power and sense of enculturated social inclusion. Sense of enculturated social inclusion demonstrated the participants "new" way of understanding social inclusion; turning social inclusion from something they feared to something they embraced. As the participants realized that social inclusion would not require them the let go of their Roma identity and culture, their Roma identity was strengthened, they became more hopeful, felt more in control and felt generally better. Despite of limited time and resources for local community directed activities, the participants perceived that improvements were achieved at the local level. In conclusions, the findings indicate that when based on the specific health needs of the people involved, basic/functional- and interactive health literacy together comprise the same idea as capacity building for health that might lead to empowerment. What found to be essential for the Roma local coordinators development of empowerment was the combination of the WIL approach, the participatory nature of the project, the trust and support from the non-Roma facilitators and Roma colleagues, and the perception of being respected as human beings and as equals. The local coordinators empowerment consisted of strengthened Roma identity, sense of power and sense of enculturated social inclusion. This indicates that the suggested WIL model/approach, comprising a participatory approach with health literacy as a tool may be a worthwhile strategy in empowering Roma people and enhancing their self-led social inclusion process. A possible road for Roma self-led integration, hence, might be through a process of enculturated social inclusion. This may also be the case for other vulnerable groups in similar situations. Further research and interventions are needed however, in order to elaborate and verify WILs' potential and sustainability in empowering other minority- and vulnerable groups

Place, publisher, year, edition, pages
University of Southern Denmark , 2015. , 74 p.
Series
Publications of the Unit for Health Promotion Research, Series A, 2015:9
Keyword [en]
Roma people, Work-integrated Learning, health
National Category
Sociology (excluding Social Work, Social Psychology and Social Anthropology)
Research subject
Work Integrated Learning; SOCIAL SCIENCE, Sociology
Identifiers
URN: urn:nbn:se:hv:diva-9864ISBN: 978-87-91245-20-6OAI: oai:DiVA.org:hv-9864DiVA: diva2:958310
Supervisors
Available from: 2016-09-06 Created: 2016-09-06 Last updated: 2016-09-06Bibliographically approved
List of papers
1. Perceptions on health, well-being and quality of life of Balkan Roma adolescents in West Sweden
Open this publication in new window or tab >>Perceptions on health, well-being and quality of life of Balkan Roma adolescents in West Sweden
2012 (English)In: Romani Studies, ISSN 1528-0748, Vol. 22, no 2, 153-173 p.Article in journal (Refereed) Published
Abstract [en]

We examine the perceptions of Roma adolescents on health, well-being and quality of life (QoL) and how the Roma managed their own life situation within these areas. The data, which consists of interviews, was analysed through content analysis. The most common understanding of health and well-being was to feel good, secure and happy. A wide social network of family and friends was seen as an additional element. The respondents perceived their own health and well-being to be good. A feeling of freedom, the ability to make decisions independently and the possibilities for education and employment were the most important elements of QoL. Quality of life was perceived to have something to do with values and beliefs in the future. Social support from family and friends were the most frequently used coping strategies. The perceptions of the Roma adolescents on health, well-being and QoL turned out to be quite similar to the perceptions of the non-Roma adolescents.

Place, publisher, year, edition, pages
United Kingdom: Liverpool University Press, 2012
Keyword
adolescents, coping strategies, health, Roma people, social capital, social networks, quality of life, well-being
National Category
Medical and Health Sciences Public Health, Global Health, Social Medicine and Epidemiology
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Public health science
Identifiers
urn:nbn:se:hv:diva-4900 (URN)10.3828/rs.2012.9 (DOI)000311330800004 ()2-s2.0-84872936069 (ScopusID)
Available from: 2012-12-18 Created: 2012-12-18 Last updated: 2016-09-06Bibliographically approved
2. The meaning of health, well-being, and quality of life perceived by Roma people in West Sweden
Open this publication in new window or tab >>The meaning of health, well-being, and quality of life perceived by Roma people in West Sweden
2013 (English)In: Societies, ISSN 1090-9389, E-ISSN 2075-4698, Vol. 3, no 2, 243-260 p.Article in journal (Refereed) Published
Abstract [en]

Many Roma people in Sweden are on the margins of society and face problems of social exclusion, institutional discrimination, low education, unemployment, and poor health. The aim is to describe how a group of Roma people, in West Sweden, understand health, well-being, and quality of life within the Roma context, and how they cope with their life-situation. Data consisted of qualitative interviews. The data were analyzed qualitatively using a phenomenological hermeneutic approach. The respondents mainly understood the concept of Health as "being healthy" and "feeling good". Elements that were crucial part of the respondents' health perception were being employed, having an education, social support from family and friends, freedom and security, and the extent of involvement in society. The results indicate that the respondents perceive their health and life situation as good, despite of their marginalized situation and discrimination.

Place, publisher, year, edition, pages
MDPI, 2013
Keyword
Roma people, health perceptions, quality of life, well-being, qualitative research
National Category
Public Health, Global Health, Social Medicine and Epidemiology Sociology (excluding Social Work, Social Psychology and Social Anthropology)
Research subject
SOCIAL SCIENCE, Sociology
Identifiers
urn:nbn:se:hv:diva-9861 (URN)10.3390/soc3020243 (DOI)
External cooperation:
Available from: 2016-09-06 Created: 2016-09-06 Last updated: 2016-09-06Bibliographically approved
3. The Nexus Between Health Literacy and Empowerment
Open this publication in new window or tab >>The Nexus Between Health Literacy and Empowerment
2016 (English)In: SAGE Open, Vol. 6, no 2Article in journal (Refereed) Published
Abstract [en]

The aim of this article was to explore what is known about the assumed connection between health literacy and empowerment and how this connection is portrayed in the scientific literature. If empowerment is an outcome of health literacy, what are the mechanisms behind this process? A literature search conducted in 2013 yielded 216 hits, of which five met the inclusion criteria, and thus were read in depth and analyzed through a narrative-review approach. The findings indicate that health literacy might be regarded as a tool for empowerment but does not automatically lead to empowerment. Health literacy might be increased by health education. Crucial for empowerment is to achieve the critical level of health literacy including an ability to question and reflect on the prevailing power relations and societal conditions; increased senses of power, self-esteem, and self-efficacy; and an ability to utilize these resources to engage in social and political action for change. This article suggests that for health literacy to be critical to empowerment, there must be a focus on social health determinants and individuals’ subjective perceptions of health and health needs. The article proposes functional and interactive health literacy as a form of capacity building for health and empowerment and critical health literacy as a way to describe empowerment. This scoping review indicates a research gap and a need for future research examining the relationship between health literacy and empowerment.

National Category
Social Work
Research subject
SOCIAL SCIENCE, Social work
Identifiers
urn:nbn:se:hv:diva-9341 (URN)10.1177/2158244016646410 (DOI)
Available from: 2016-05-09 Created: 2016-05-09 Last updated: 2016-09-06Bibliographically approved
4. Work-integrated learning and health literacy: catalysts for Roma empowerment and social inclusion
Open this publication in new window or tab >>Work-integrated learning and health literacy: catalysts for Roma empowerment and social inclusion
2014 (English)Article in journal (Refereed) Submitted
Keyword
Work-integrated learning, health
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Work Integrated Learning; SOCIAL SCIENCE, Sociology; NURSING AND PUBLIC HEALTH SCIENCE, Public health science
Identifiers
urn:nbn:se:hv:diva-9862 (URN)
External cooperation:
Note

Ingår i avhandling

Available from: 2016-09-06 Created: 2016-09-06 Last updated: 2016-09-06Bibliographically approved
5. Roma Empowerment and social inclusion through Work-Integrated Learning
Open this publication in new window or tab >>Roma Empowerment and social inclusion through Work-Integrated Learning
2015 (English)In: SAGE Open, ISSN 2158-2440, E-ISSN 2158-2440, no jan-march, 1-10 p.Article in journal (Refereed) Published
Abstract [en]

The basis for this article was a health promotion program based on participatory action research and work-integrated learning (WIL). Seven Roma people were employed and trained to work as local coordinators to empower the local Roma community by strengthening their participation in society and their sense of community, as well as to promote self-led integration. The study aimed to analyze the program from the Roma coordinators' perspectives, focusing on perceived individual empowerment and perceptions of contribution to the common good and to community empowerment. The findings, based on qualitative data, primarily interviews with the Roma coordinators, indicated that the WIL approach, the participatory nature of the program, and the trust and support from the Roma colleagues and non-Roma facilitators were essential for the development of empowerment. Three main themes emerged that portrayed the participants' psychological empowerment: strengthened Roma identity, a sense of power, and a sense of enculturated social inclusion.

Place, publisher, year, edition, pages
SAGE Open, 2015
Keyword
Empowerment, participatory action research, Roma people, social inclusion, work-integrated learning
National Category
Sociology (excluding Social Work, Social Psychology and Social Anthropology)
Research subject
Work Integrated Learning; SOCIAL SCIENCE, Sociology
Identifiers
urn:nbn:se:hv:diva-9863 (URN)10.1177/2158244015572275 (DOI)
External cooperation:
Available from: 2016-09-06 Created: 2016-09-06 Last updated: 2016-09-06Bibliographically approved

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