Stakeholders’ expectations of Healthy Life Centers: A focus group study

Abstract

The Norwegian HLC is still a concept in development and is trying to define its position in the public healthcare system. In accordance with national recommendations to reduce social health inequalities, the stakeholders emphasized providing effective, evidence-based HLC programs including underprivileged groups. They also expressed concern about prioritizing between an individual and population approach, and between different target groups and tasks.

Individual user involvement at Healthy Life Centres: a qualitative study exploring the perspective of health professionals

“…This is in line with many other studies showing that an optimal level of involvement depends on both users and professionals having adequate time to build relationships and share knowledge (Angel & Frederiksen, 2015; Leske, Strodl, & Hou, 2012; Rise et al, 2013; Sahlsten et al, 2009; Tobiano et al, 2015). On the other hand, the users’ often complex life challenges and conditions were described as a potential hindrance for user involvement, which is in accordance with other studies pointing out that users’ physical and mental capabilities, severe illness and poor health can impede involvement (Angel & Frederiksen, 2015; Longtin et al, 2010; Rise et al, 2013; Solbjør, Rise, Westerlund, & Steinsbekk, 2013; Tobiano et al, 2015) and health behaviour change (Abildsnes et al, 2017, 2016; Følling et al, 2015). In addition, our findings showed that the building of a trustful relationship and individualization of the service was disturbed by the use of standardized forms which interrupted the communication process.…”

“…However, emphasizing an individual focus of involvement and personal responsibility is described as a balancing act between responsibility and blame, which may result in stigmatizing instead of health promotion (Abildsnes et al, 2016; Malterud & Tonstad, 2009; Malterud & Ulriksen, 2011). Thus, acknowledging that some users do not want to be involved can also be regarded as self-determination.…”

“…The HLCs are easily accessible, and people can attend the service through referral from a general practitioner (GP) or other health care providers or by self-referral (Norwegian Directorate of Health, 2016). The HLCs offers knowledge-based support for changing living habits and coping with health challenges through individual- and group-based counselling and activities, and use client-centred counselling approaches to promote the participants’ internal motivation, empowerment and coping (Abildsnes, Meland, Samdal, Stea, & Mildestvedt, 2016; Følling, Solbjør, & Helvik, 2015; Lerdal, Celius, & Pedersen, 2013; Norwegian Directorate of Health, 2016). …”

Respect, trust and continuity: A qualitative study exploring service users’ experience of involvement at a Healthy Life Centre in Norway

“…Instead, service users described guidance by the professionals as positive, preferring a more passive role due to their own psychological distress and inexperience. This is in accordance with findings showing that psychological distress and disease can challenge user involvement and health behaviour changes . The service users’ choice of letting the professionals decide has also been considered as result of a service user‐professional relationship characterized by trust, which gives confidence to allow others to decide on one's behalf .…”

“…The HLC is an easily accessible primary care service that people can attend through referral from a general practitioner, other health‐care provider or by self‐referral . The HLCs direct their services towards people who need help to change living habits related to healthy diet, physical activity and tobacco cessation . Intervention periods of 12 weeks are offered, with the possibility to extend the intervention twice; hence, at some HLCs, a total of 36 weeks of intervention can be experienced.…”