Possibilities and challenges in developing and implementing an empowerment-based school-intervention in a Swedish disadvantaged community

Abstract

In this paper, we describe and critically reflect on the possibilities and challenges of developing and implementing an empowerment-based school intervention regarding healthy food and physical activity (PA), involving participants from a Swedish multicultural area characterized by low socioeconomic status. The 2-year intervention was continually developed and implemented, as a result of cooperation and shared decision making among researchers and the participants. All 54 participants were seventh graders, and the intervention comprised health coaching, health promotion sessions and a Facebook group. We experienced that participants valued collaborating with peers, and that they took responsibility in codeveloping and implementing the intervention. Participants expressed feeling listened to, being treated with respect and taken seriously. However, we also experienced a number of barriers that challenged our initial intentions of aiding participation and ambition to support empowerment. Moreover, it was challenging to use structured group health coaching and to work with goal-setting in groups of participants with shared, and sometimes competing, goals, wishes and needs related to food and PA. Successful experiences from this intervention was the importance of acquiring a broad and deep understanding of the context and participants, being open to negotiating, as well as adjusting the intervention.

“Not Only Adults Can Make Good Decisions, We as Children Can Do That as Well” Evaluating the Process of the Youth-Led Participatory Action Research ‘Kids in Action’

“…By developing and implementing actions together with children, 'Kids in Action' tried to work on the level of participation of shared control and decision-making power between children and adults [14,27,28,30]. On this level children are taken seriously, they work on actions and see their own actions being implemented [18]. When children are involved in advocacy and organizing, this can lead to environmental outcomes such as changes in peer norms and program development [11].…”

“…However, when children evaluated the actions, they seemed to had forgotten this process and felt they had been limited by the boundaries of healthy foods. This shows it is important to constantly reflect with the children on the goals of the study and together create a clear understanding of the responsibilities and rationale [18,28].…”

“…Collaborations between academics and community organizations may provide an enabling environment for successful YPAR [34]. Crucial in 'Kids in Action' was that the community partners were interested in child participation and understood the power dynamics between children and adults in YPAR, which helps gain support for such a study [18,35,36]. Community partners were willing to collaborate with children to develop their ideas for actions and when necessary integrate it in their organization's policies.…”

“…Remarkably, few process evaluations of YPAR studies are published [17]. As participation of the target group in action development has recently gained increasing popularity, process evaluations of YPAR studies are urgently needed to gain insight into essential preconditions and challenges [18]. This article describes the qualitative process evaluation of 'Kids in Action' including the participatory process, the developed actions, and the outcomes of the study from the perspective of children and community partners.…”

Effects of an Empowerment-Based Health-Promotion School Intervention on Physical Activity and Sedentary Time among Adolescents in a Multicultural Area

“…The design of the intervention was similar to what Salazar et al [ 15 ] describe as a quasi-experimental, non-randomized, longitudinal pretest-posttest design. For further information about the intervention design, its development, and implementation see Jonsson et al [ 16 ]. Although the intervention addressed both PA and food habits, for the purpose of this paper, we only evaluated the effects of the intervention on PA and sedentary time.…”