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  • 1. Briones-Vozmediano, Erica
    et al.
    Maquibar, Amaia
    Vives-Cases, Carmen
    Öhman, Ann
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Hurtig, Anna-Karin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Goicolea, Isabel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Public Health Research Group of the University of Alicante, Spain.
    Health-Sector Responses to Intimate Partner Violence: fitting the Response Into the Biomedical Health System or Adapting the System to Meet the Response?2018In: Journal of Interpersonal Violence, ISSN 0886-2605, E-ISSN 1552-6518, Vol. 33, no 10, p. 1653-1678Article in journal (Refereed)
    Abstract [en]

    This study aims to analyze how middle-level health systems' managers understand the integration of a health care response to intimate partner violence (IPV) within the Spanish health system. Data were obtained through 26 individual interviews with professionals in charge of coordinating the health care response to IPV within the 17 regional health systems in Spain. The transcripts were analyzed following grounded theory in accordance with the constructivist approach described by Charmaz. Three categories emerged, showing the efforts and challenges to integrate a health care response to IPV within the Spanish health system: "IPV is a complex issue that generates activism and/or resistance," "The mandate to integrate a health sector response to IPV: a priority not always prioritized," and "The Spanish health system: respectful with professionals' autonomy and firmly biomedical." The core category, "Developing diverse responses to IPV integration," crosscut the three categories and encompassed the range of different responses that emerge when a strong mandate to integrate a health care response to IPV is enacted. Such responses ranged from refraining to deal with the issue to offering a women-centered response. Attempting to integrate a response to nonbiomedical health problems as IPV into health systems that remain strongly biomedicalized is challenging and strongly dependent both on the motivation of professionals and on organizational factors. Implementing and sustaining changes in the structure and culture of the health care system are needed if a health care response to IPV that fulfills the World Health Organization guidelines is to be ensured.

  • 2. Briones-Vozmediano, Erica
    et al.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Goicolea, Isabel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Public Health Research Group of Alicante University, Alicante, Spain.
    Vives-Cases, Carmen
    "The complaining women": health professionals' perceptions on patients with fibromyalgia in Spain2018In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, no 14, p. 1679-1685Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim of this study is twofold: (1) to explore health service providers' perceptions regarding fibromyalgia patients in Spain and (2) to analyze possible consequences of these perceptions in terms of how health service providers construct the disease and treat their patients.

    DESIGN: Qualitative study.

    SUBJECTS/PATIENTS: Twelve health service providers (eight men, four women) involved in the care of fibromyalgia patients. Providers were from different disciplines and included general practitioners, rheumatologists, occupational doctors, psychologists, psychiatrists, physiotherapists and behavioral specialists from Spain.

    METHOD: We performed individual semistructured interviews, which were recorded and transcribed to conduct a qualitative content analysis supported by Atlas.ti-7.

    RESULTS: We identified three categories from the interviews: (1) the fibromyalgia patient prototype: the complaining woman, (2) fibromyalgia is considered a women's health issue, but male patients are a privileged minority, and (3) health professionals' attitudes toward fibromyalgia patients: are they really suffering or pretending?

    CONCLUSION: The uncertainty surrounding fibromyalgia together with the fact that those affected are primarily women, seem to influence professional practice in terms of lack of recognition of Fibromyalgia as a severe disease. Increased training of all health professionals is essential to improving the support and attention given to patients suffering from fibromyalgia.

    Implications for rehabilitation: Fibromyalgia

    • In order to improve fibromyalgia patients' attention, health providers should learn how to assist patients without prejudices.

    • Training programs for health providers should include sensitization about the severity of fibromyalgia.

    • Health providers should be aware of the existence of stereotypes about women suffering from fibromyalgia.

    • Fibromyalgia protocols should give skills to health providers to avoid offering a gender-biased attention to patients.

  • 3.
    Burman, Monica
    et al.
    Umeå University, Faculty of Social Sciences, Umeå Forum for Studies on Law and Society.
    Öhman, Ann
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Challenging gender and violence: Positions and discourses in Swedish and international contexts2014In: Women's Studies: International Forum, ISSN 0277-5395, E-ISSN 1879-243X, Vol. 46, p. 81-82Article in journal (Other academic)
  • 4.
    Coe, Anna-Britt
    et al.
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Goicolea, Isabel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    How gender hierarchies matter in youth activism: young people's mobilizing around sexual health in Ecuador and Peru2013In: Journal of Youth Studies, ISSN 1367-6261, E-ISSN 1469-9680, Vol. 16, no 6, p. 695-711Article in journal (Refereed)
    Abstract [en]

    Despite a growing body of research on youth activism, few studies examine how this intersects with gender. Our study aimed to explore whether and how young activists themselves perceived gender hierarchies as needing to be addressed through their collective action on sexual health in Peru and Ecuador. Using Grounded Theory, qualitative data was collected and analyzed from young activists across four cases. Cases ranged in complexity from a single youth organization operating at the district level to numerous youth organizations articulating at the national level. We linked the GT analysis to a conceptual framework based on Tayor’s (1999) theorizing of gender and social movements. Accordingly, young activists perceived gender, and even class, “race” and age, as salient to their collective actions. These actions corresponded to the social movement concept of mobilizing structures that consist of pre-existing structures, tactics and organizations. Young activists understood gender and other social categories as imbued by power differentials and therefore as social hierarchies, within which their activism was embedded. The paper thereby demonstrates the need for an enhanced conceptual framework for the study of youth activism and its intersection with gender hierarchies.

  • 5. Cronesten, H
    et al.
    Johansson, H
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Insikt, motivation och stöd är viktiga faktorer för viktnedgång: uppfattningar från ett förebyggande hälsoprojekt2003In: Nordisk fysioterapi, ISSN 1402-3024, Vol. 7, p. 1-8Article in journal (Refereed)
  • 6.
    Dewi, Fatwa Sari Tetra
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Public Health Division, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Marlinawati, V. Utari
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Weinehall, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Centre for Population Studies (CPS).
    A community intervention for behaviour modification: an experience to control cardiovascular diseases in Yogyakarta, Indonesia2013In: BMC Public Health, E-ISSN 1471-2458, Vol. 13, article id 1043Article in journal (Refereed)
    Abstract [en]

    Background: Non-communicable Disease (NCD) is increasingly burdening developing countries including Indonesia. However only a few intervention studies on NCD control in developing countries are reported. This study aims to report experiences from the development of a community-based pilot intervention to prevent cardiovascular disease (CVD), as initial part of a future extended PRORIVA program (Program to Reduce Cardiovascular Disease Risk Factors in Yogyakarta, Indonesia) in an urban area within Jogjakarta, Indonesia.

    Methods: The study is quasi-experimental and based on a mixed design involving both quantitative and qualitative methods. Four communities were selected as intervention areas and one community was selected as a referent area. A community-empowerment approach was utilized to motivate community to develop health promotion activities. Data on knowledge and attitudes with regard to CVD risk factors, smoking, physical inactivity, and fruit and vegetable were collected using the WHO STEPwise questionnaire. 980 people in the intervention areas and 151 people in the referent area participated in the pre-test. In the post-test 883 respondents were re-measured from the intervention areas and 144 respondents from the referent area. The qualitative data were collected using written meeting records (80), facilitator reports (5), free-listing (112) and in-depth interviews (4). Those data were analysed to contribute a deeper understanding of how the population perceived the intervention.

    Results: Frequency and participation rates of activities were higher in the low socioeconomic status (SES) communities than in the high SES communities (40 and 13 activities respectively). The proportion of having high knowledge increased significantly from 56% to 70% among men in the intervention communities. The qualitative study shows that respondents thought PRORIVA improved their awareness of CVD and encouraged them to experiment healthier behaviours. PRORIVA was perceived as a useful program and was expected for the continuation. Citizens of low SES communities thought PRORIVA was a “cheerful” program.

    Conclusion: A community-empowerment approach can encourage community participation which in turn may improve the citizen’s knowledge of the danger impact of CVD. Thus, a bottom-up approach may improve citizens’ acceptance of a program, and be a feasible way to prevent and control CVD in urban communities within a low income country.

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  • 7.
    Dewi, Fatwa Sari Tetra
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Hakimi, Mohammad
    Center for Health and Nutrition Research Laboratory, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia.
    Weinehall, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Mobilising a disadvantaged community for a cardiovascular intervention: designing PRORIVA in Yogyakarta, Indonesia2010In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 3, p. 4661-Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Cardiovascular disease (CVD) is a burden for developing countries, yet few CVD intervention studies have been conducted in developing countries such as Indonesia. This paper outlines the process of designing a community intervention programme to reduce CVD risk factors, and discusses experiences with regard to design issues for a small-scale intervention.

    DESIGN PROCESS: THE DESIGN PROCESS FOR THE PRESENT COMMUNITY INTERVENTION CONSISTED OF SIX STAGES: (1) a baseline risk factor survey, (2) design of a small-scale intervention by using both baseline survey and qualitative data, (3) implementation of the small-scale intervention, (4) evaluation of the small-scale intervention and design of a broader CVD intervention in the Yogyakarta municipality, (5) implementation of the broader intervention and (6) evaluation of the broader CVD intervention. According to the baseline survey, 60% of the men were smokers, more than 30% of the population had insufficient fruit and vegetable intake and more than 30% of the population were physically inactive, this is why a small-scale population intervention approach was chosen, guided both by the findings in the quantitative and the qualitative study.

    EXPERIENCES: A quasi-experimental study was designed with a control group and pre- and post-testing. In the small-scale intervention, two sub-districts were selected and randomly assigned as intervention and control areas. Within them, six intervention settings (two sub-villages, two schools and two workplaces) and three control settings (a sub-village, a school and a workplace) were selected. Health promotion activities targeting the whole community were implemented in the intervention area. During the evaluation, more activities were performed in the low socioeconomic status sub-village and at the civil workplace.

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    Mobilising a disadvantaged community for a cardiovascular intervention: designing PRORIVA in Yogyakarta, Indonesia
  • 8.
    Dewi, Fatwa Sari Tetra
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Weinehall, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    'Maintaining balance and harmony': Javanese perceptions of health and cardiovascular disease2010In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 3Article in journal (Refereed)
    Abstract [en]

    Community intervention programmes to reduce cardiovascular disease (CVD) risk factors within urban communities in developing countries are rare. One possible explanation is the difficulty of designing an intervention that corresponds to the local context and culture.

    Objectives: To understand people’s perceptions of health and CVD, and how people prevent CVD in an urban setting in Yogyakarta, Indonesia.

    Methods: A qualitative study was performed through focus group discussions and individual research interviews. Participants were selected purposively in terms of socio-economic status (SES), lay people, community leaders and government officers. Data were analysed by using content analysis.

    Results: Seven categories were identified: (1) heart disease is dangerous, (2) the cause of heart disease, (3) men have no time for health, (4) women are caretakers for health, (5) different information-seeking patterns, (6) the role of community leaders and (7) patterns of lay people’s action. Each category consists of sub-categories according to the SES of participants. The main theme that emerged was one of balance and harmony, indicating the necessity of assuring a balance between ‘good’ and ‘bad’ habits.

    Conclusions: The basic concepts of balance and harmony, which differ between low and high SES groups, must be understood when tailoring community interventions to reduce CVD risk factors. The basic concepts of balance and harmony, which differ between low and high SES groups, must be understood when tailoring community interventions to reduce CVD risk factors.

  • 9.
    Enberg, Birgit
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nordin, Catharina
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Work experiences of novice occupational therapists and physiotherapists in public sector employment: analyses using two occupational stress models2010In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 12, no 1, p. 42-49Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to evaluate how recently graduated occupational therapists and physiotherapists, employed by the Swedish county councils and municipalities, experience working in public sector healthcare organization. The study group, 262 occupational therapists and physiotherapists who graduated in 1999, is a sub-sample drawn from a national cross-sectional survey. Data were collected in their third year after graduation. The Swedish Demand-control Questionnaire and the Effort-reward Imbalance Questionnaire together with self-constructed questions were used to evaluate psychosocial factors at work. The results reveal that few were exposed to job strain or effort-reward imbalance (ERI). More were defined as having work-related overcommitment (WOC). Logistic regression analyses revealed a significant association between WOC and ERI, sex, degree of effort and degree of reward. One quarter was dissatisfied with their work and this dissatisfaction was significantly associated with ERI, reward (in the ERI questionnaire), control (in the Demand-control Questionnaire) and type of employer. In conclusion, combining the Demand-control model and the ERI model made it possible to describe and analyse varying aspects of the work of novice occupational therapists and physiotherapists in public sector healthcare.

  • 10.
    Enberg, Birgit
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Work satisfaction, career preferences and unpaid household work among recently graduated health-care professionals: a gender perspective2007In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, no 2, p. 169-177Article in journal (Refereed)
  • 11.
    Enberg, Birgit
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Work experiences among nurses and physicians in the beginning of their professional careers - analyses using the effort-reward imbalance model2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, ISSN 0283-9318, Vol. 27, no 1, p. 36-43Article in journal (Refereed)
    Abstract [en]

    Work experiences among nurses and physicians in the beginning of their professional careers analyses using the effortreward imbalance model The aim of the study was to scrutinise how nurses and physicians, employed by the county councils in Sweden, assess their work environment in terms of effort and reward at the start of their career. The aim was also to estimate associations between work satisfaction and the potential outcomes from the effortreward imbalance (ERI) questionnaire. The study group, 198 nurses and 242 physicians who graduated in 1999, is a subsample drawn from a national cross-sectional survey. Data were collected in the third year after graduation among the nurses and in the fourth year after graduation among registered physicians. The effortreward imbalance questionnaire, together with a question on work satisfaction, was used to evaluate psychosocial factors at work. The results reveal that nurses scored higher on effort, lower on reward and experienced higher effortreward imbalance, compared with physicians. Women scored higher on work-related overcommitment (WOC) compared with men. Among the physicians, logistic regression analysis revealed a statistically significant association between WOC and ERI, sex, effort and reward. Logistic regression analysis also revealed a statistically significant association between WOC and ERI and between WOC and effort among the nurses. Dissatisfaction with work was significantly higher among those who scored worst on all three ERI subscales (effort, reward and WOC) and also among those with the highest ERI ratios compared with the other respondents. In conclusion, to prevent future work-related health problems and work dissatisfaction among nurses and physicians in the beginning of their professional careers, signs of poor psychosocial working conditions have to been taken seriously. In future work-related stress research among healthcare personnel, gender-specific aspects of working conditions must be further highlighted to develop more gender-sensitive analyses.

  • 12.
    Enberg, Birgit
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Work experiences among nurses and physicians in the beginning of their professional careers: analyses using the effort-reward imbalance modelManuscript (preprint) (Other academic)
  • 13.
    Goicolea, Isabel
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Public Health Research Group, Department of Community Nursing, Alicante, Spain.
    Briones-Vozmediano, Erica
    Öhman, Ann
    Preventive Medicine and Public Health and History of Science, Alicante University, Alicante, Spain.
    Edin, Kerstin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Minvielle, Fauhn
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Vives-Cases, Carmen
    Public Health Research Group, Department of Community Nursing, Alicante and CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain.
    Mapping and exploring health systems' response to intimate partner violence in Spain2013In: BMC Public Health, E-ISSN 1471-2458, Vol. 13, no 1, article id 1162Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: For a comprehensive health sector response to intimate partner violence (IPV), interventions should target individual and health facility levels, along with the broader health systems level which includes issues of governance, financing, planning, service delivery, monitoring and evaluation, and demand generation. This study aims to map and explore the integration of IPV response in the Spanish national health system.

    METHODS: Information was collected on five key areas based on WHO recommendations: policy environment, protocols, training, monitoring and prevention. A systematic review of public documents was conducted to assess 39 indicators in each of Spain's 17 regional health systems. In addition, we performed qualitative content analysis of 26 individual interviews with key informants responsible for coordinating the health sector response to IPV in Spain.

    RESULTS: In 88% of the 17 autonomous regions, the laws concerning IPV included the health sector response, but the integration of IPV in regional health plans was just 41%. Despite the existence of a supportive national structure, responding to IPV still relies strongly on the will of health professionals. All seventeen regions had published comprehensive protocols to guide the health sector response to IPV, but participants recognized that responding to IPV was more complex than merely following the steps of a protocol. Published training plans existed in 43% of the regional health systems, but none had institutionalized IPV training in medical and nursing schools. Only 12% of regional health systems collected information on the quality of the IPV response, and there are many limitations to collecting information on IPV within health services, for example underreporting, fears about confidentiality, and underuse of data for monitoring purposes. Finally, preventive activities that were considered essential were not institutionalized anywhere.

    CONCLUSIONS: Within the Spanish health system, differences exist in terms of achievements both between regions and between the areas assessed. Progress towards integration of IPV has been notable at the level of policy, less outstanding regarding health service delivery, and very limited in terms of preventive actions.

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  • 14.
    Goicolea, Isabel
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Coe, Anna-Britt
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Easy to Oppose, Difficult to Propose: Young Activist Men's Framing of Alternative Masculinities under the Hegemony of Machismo in Ecuador2014In: Young - Nordic Journal of Youth Research, ISSN 1103-3088, E-ISSN 1741-3222, Vol. 22, no 4, p. 399-419Article in journal (Refereed)
    Abstract [en]

    Debates are ongoing on whether man can engage in gender change and challenge hegemonic masculinities. The study aimed to analyze in what ways young Ecuadorian mencurrently or recently involved in activism to advance gender equality and reproductive rightsdefined different masculinities, hegemonic and alternative. We used Grounded Theory to collect and analyze three focus group discussions and 15 individual interviews with 30 young activist men in Ecuador. A core category captured the process of defining masculinities: Moving from passive acceptance of machismo to critical reflection and action' that in turn linked to three theoretical categories: Opposing machismo', From machos to men', and Inspiring opposition to machismo'. We drew upon framing theory in social movement studies to interpret the findings and thereby enhance the theory of hegemonic masculinity. Young activist men successfully framed the problem and motives for collective mobilization, but they wavered when it came to framing solutions.

  • 15.
    Goicolea, Isabel
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Salazar Torres, Mariano
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Edin, Kerstin
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Öhman, Ann
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    When sex is hardly about mutual pleasure: Dominant and resistant discourses on sexuality and its consequences for young people's sexual health2012In: International Journal of Sexual Health, ISSN 1931-7611, E-ISSN 1931-762X, Vol. 24, no 4, p. 303-317Article in journal (Refereed)
    Abstract [en]

    This study explores gendered discourses about sexuality in Ecuador, the consequences of these discourses for young people's sexual health, and the possibility of the emergence of resistance and challenge. We analyzed and compared individual interviews and focus-group discussions with: young women, youth service providers, ordinary young men, and activist young men. Five interpretative repertoires emerged: (1) becoming sexually respectable women, (2) policing young women's sexuality, (3) men threatening and protecting women, (4) sexual relations (abusing, fooling, or seducing?), and (5) emerging resistance. The repertoires constructed a hierarchy of sexualities in which heterosexual monogamous lifelong coupledom was normative and women's pleasure was absent, but resistance was emerging.

  • 16.
    Goicolea, Isabel
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Vives-Cases, Carmen
    Minvielle, Fauhn
    Briones-Vozmediano, Erica
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Applying the WHO recommendations on health-sector response to violence against women to assess the Spanish health system: a mixed methods approach2014In: Gaceta Sanitaria, ISSN 0213-9111, E-ISSN 1578-1283, Vol. 28, no 3, p. 238-41Article in journal (Refereed)
    Abstract [en]

    This methodological note describes the development and application of a mixed-methods protocol to assess the responsiveness of Spanish health systems to violence against women in Spain, based on the World Health Organization (WHO) recommendations.

    Five areas for exploration were identified based on the WHO recommendations: policy environment, protocols, training, accountability/monitoring, and prevention/promotion. Two data collection instruments were developed to assess the situation of 17 Spanish regional health systems (RHS) with respect to these areas: 1) a set of indicators to guide a systematic review of secondary sources, and 2) an interview guide to be used with 26 key informants at the regional and national levels.

    We found differences between RHSs in the five areas assessed. The progress of RHSs on the WHO recommendations was notable at the level of policies, moderate in terms of health service delivery, and very limited in terms of preventive actions. Using a mixed-methods approach was useful for triangulation and complementarity during instrument design, data collection and interpretation.

  • 17.
    Goicolea, Isabel
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Wulff, Marianne
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    San Sebastian, Miguel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Adolescent pregnancies and girls' sexual and reproductive rights in the Amazon Basin of Ecuador: an analysis of providers' and policy makers' discourses2010In: BMC International Health and Human Rights, E-ISSN 1472-698X, Vol. 10, no 12Article in journal (Refereed)
    Abstract [en]

    Background: Adolescent pregnancies are a common phenomenon that can have both positive and negative consequences. The rights framework allows us to explore adolescent pregnancies not just as isolated events, but in relation to girls' sexual and reproductive freedom and their entitlement to a system of health protection that includes both health services and the so called social determinants of health. The aim of this study was to explore policy makers' and service providers' discourses concerning adolescent pregnancies, and discuss the consequences that those discourses have for the exercise of girls' sexual and reproductive rights' in the province of Orellana, located in the amazon basin of Ecuador.

    Methods: We held six focus-group discussions and eleven in-depth interviews with 41 Orellana's service providers and policy makers. Interviews were transcribed and analyzed using discourse analysis, specifically looking for interpretative repertoires.

    Results: Four interpretative repertoires emerged from the interviews. The first repertoire identified was "sex is not for fun" and reflected a moralistic construction of girls' sexual and reproductive health that emphasized abstinence, and sent contradictory messages regarding contraceptive use. The second repertoire -"gendered sexuality and parenthood"-constructed women as sexually uninterested and responsible mothers, while men were constructed as sexually driven and unreliable. The third repertoire was "professionalizing adolescent pregnancies" and lead to patronizing attitudes towards adolescents and disregard of the importance of non-medical expertise. The final repertoire -"idealization of traditional family"-constructed family as the proper space for the raising of adolescents while at the same time acknowledging that sexual abuse and violence within families was common.

    Conclusions: Providers' and policy makers' repertoires determined the areas that the array of sexual and reproductive health services should include, leaving out the ones more prone to cause conflict and opposition, such as gender equality, abortion provision and welfare services for pregnant adolescents. Moralistic attitudes and sexism were present - even if divergences were also found-, limiting services' capability to promote girls' sexual and reproductive health and rights.

  • 18.
    Goicolea, Isabel
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Wulff, Marianne
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Gender structures constraining girls’ agency: exploring pregnancy and motherhood among adolescent gilrs in Ecuador’s Amazon Basin2010In: Sexuality, Health and Society, ISSN 1984-6487, Vol. 5, p. 50-73Article in journal (Refereed)
  • 19.
    Goicolea, Isabel
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Wulff, Marianne
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Gender structures constraining girls' agency: exploring pregnancy and motherhood among adolescent girls in Ecuador's Amazon basinManuscript (preprint) (Other academic)
  • 20.
    Goicolea, Isabel
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Wulff, Marianne
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    San Sebastian, Miguel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Risk factors for pregnancy among adolescent girls in Ecuador's Amazon basin: a case-control study2009In: Revista panamericana de salud pùblica, ISSN 1020-4989, E-ISSN 1680-5348, Vol. 26, no 3, p. 221-228Article in journal (Refereed)
    Abstract [en]

    Objective. To examine risk factors for pregnancy among adolescent girls in the Amazonbasin of Ecuador.Methods. A matched case-control study with cases and controls identified within a community-based demographic and health survey was conducted in Orellana, Ecuador, from Mayto November 2006. A questionnaire focused on socioeconomic status, family structure, education,reproductive health, and childhood-adolescent trauma was applied. Conditional logisticregression was used to adjust for potential confounders.Results. Respondents included 140 cases and 262 controls. Factors associated with increasedrisk of adolescent pregnancies through multivariate analysis were: sexual abuse duringchildhood-adolescence (odds ratio (OR) 3.06, 95% confidence interval (CI) 1.08–8.68);early sexual debut (OR 8.51, 95% CI 1.12–64.90); experiencing periods without mother andfather (OR 10.67, 95% CI 2.67–42.63); and living in a very poor household (OR 15.23, 95%CI 1.43–162.45). Another two factors were statistically associated in the bivariate analysis:being married or in a consensual union (OR 44.34, 95% CI 17.85–142.16) and not being enrolledin school at the time of the interview (OR 6.31, 95% CI 3.70–11.27). For a subsampleof sexually initiated adolescents, “non-use of contraception during first sexual intercourse”was also found to be a risk factor (OR 4.30, 95% CI 1.33–13.90).Conclusion. The study found that early sexual debut, non-use of contraception during firstsexual intercourse, living in a very poor household, having suffered from sexual abuse duringchildhood-adolescence, and family disruption (living extended periods of life without both parents)were associated with adolescent pregnancy in Orellana.

  • 21.
    Goicolea, Isabel
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Öhman, Ann
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Salazar Torres, Mariano
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Morras, Ione
    Medicus Mundi Gipuzkoa, San Sebastian, Spain; Red de Prevencio´ n y Atencio´ n de la Violencia de Francisco de Orellana, Coca, Ecuador.
    Edin, Kerstin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Condemning violence without rejecting sexism?: exploring how young men understand intimate partner violence in Ecuador2012In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 5, no 1, article id 18049Article in journal (Refereed)
    Abstract [en]

    Background: This study aims to explore young men's understanding of intimate partner violence (IPV) in Ecuador, examining similarities and differences between how ordinary and activist young men conceptualize IPV against women. Methods: We conducted individual interviews and focus group discussions (FGDs) with 35 young men - five FGDs and five interviews with ordinary young men, and 11 interviews with activists - and analysed the data generated using qualitative content analysis. Results: Among the ordinary young men the theme 'too much gender equality leads to IPV' emerged, while among the activists the theme 'gender inequality is the root of IPV'. Although both groups in our study rejected IPV, their positions differed, and we claim that this is relevant. While activists considered IPV as rooted in gender inequality, ordinary young men understood it as a response to the conflicts generated by increasing gender equality and women's attempts to gain autonomy.

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  • 22.
    Goicolea, Isabel
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Öhman, Ann
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Vives-Cases, Carmen
    Intersections between gender and other relevant social determinants of health inequalities2017In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 10, article id 1397909Article in journal (Refereed)
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  • 23. Gustafsson, Monika
    et al.
    Ekholm, Jan
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    From shame to respect: musculoskeletal pain patients' experience of a rehabilitation programme, a qualitative study2004In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 36, no 3, p. 97-103Article in journal (Refereed)
    Abstract [en]

    Objective: This study aimed to describe and analyse how participants with fibromyalgia or chronic, widespread, musculoskeletal pain, 1 year after completion, experienced a rehabilitation programme; and what knowledge and strategies they had gained.

    Design, methods and subjects: Semi-structured interviews with 16 female patients were analysed using the grounded theory method of constant comparison.

    Results: One core category, from shame to respect, and 4 categories, developing body awareness/knowledge, setting limits, changing self-image and negative counterbalancing factors, and hopelessness and frustration over one's employment situation emerged from the data. The core category represents a process where the informants changed emotionally. Three categories were identified as important for starting and maintaining the process, one category affected the process negatively.

    Conclusion: The rehabilitation programme started the process of change, from shame to respect. The informants learned new strategies for handling their pain and other symptoms; they improved their self-image and communication in their social environment.

  • 24. Gustavsson, M
    et al.
    Ekholm, J
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    From shame to respect - musculoskeletal pain patients' experiences of rehabilitation2004In: Rehabilitation Medicine, Vol. 36, p. 97-103Article in journal (Refereed)
  • 25. Hjort, I
    et al.
    Lundberg, E
    Ekergård, H
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Motivation till hemträning hos patienter med reumatoid artrit: en kvalitativ intervjustudie1999In: Nordisk fysioterapi, ISSN 1402-3024, Vol. 3, p. 31-37Article in journal (Refereed)
  • 26. Hoa, Nguyen Quynh
    et al.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Lundborg, Cecilia Stålsby
    Chuc, Nguyen Thi Kim
    Drug use and health-seeking behavior for childhood illness in Vietnam--a qualitative study.2007In: Health Policy, ISSN 0168-8510, Vol. 82, no 3, p. 320-9Article in journal (Refereed)
  • 27.
    Joffer, Junia
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Center for Clinical Research Dalarna-Uppsala University.
    Jerdén, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Center for Clinical Research Dalarna-Uppsala University; School of Education, Health and Social Studies, Dalarna University.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Flacking, Renée
    School of Education, Health and Social Studies, Dalarna University.
    Exploring self-rated health among adolescents: a think-aloud study2016In: BMC Public Health, E-ISSN 1471-2458, Vol. 16, article id 156Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Despite extensive use of self-rated health questions in youth studies, little is known about what such questions capture among adolescents. Hence, the aim of this study was to explore how adolescents interpret and reason when answering a question about self-rated health.

    METHODS: A qualitative study using think-aloud interviews explored the question, "How do you feel most of the time?", using five response options ("Very good", "Rather good", "Neither good, nor bad", "Rather bad", and "Very bad"). The study involved 58 adolescents (29 boys and 29 girls) in lower secondary school (7th grade) and upper secondary school (12th grade) in Sweden.

    RESULTS: Respondents' interpretations of the question about how they felt included social, mental, and physical aspects. Gender differences were found primarily in that girls emphasized stressors, while age differences were reflected mainly in the older respondents' inclusion of a wider variety of influences on their assessments. The five response options all demonstrated differences in self-rated health, and the respondents' understanding of the middle option, "Neither good, nor bad", varied widely. In the answering of potential sensitive survey questions, rationales for providing honest or biased answers were described.

    CONCLUSIONS: The use of a self-rated health question including the word 'feel' captured a holistic view of health among adolescents. Differences amongst response options should be acknowledged when analyzing self-rated health questions. If anonymity is not feasible when answering questions on self-rated health, a high level of privacy is recommended to increase the likelihood of reliability.

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  • 28.
    Joffer, Junia
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Randell, Eva
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Flacking, René
    Bergström, E.
    Jerdén, Lars
    Subjective social status and health in adolescence: a mixed methods studyManuscript (preprint) (Other academic)
  • 29.
    Joffer, Junia
    et al.
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Center for Clinical Research Dalarna-Uppsala University, Falun, Sweden.
    Randell, Eva
    School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Flacking, Renée
    School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
    Jerdén, Lars
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Center for Clinical Research Dalarna-Uppsala University, Falun, Sweden; School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
    Playing the complex game of social status in school – a qualitative study2020In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 13, no 1, article id 1819689Article in journal (Refereed)
    Abstract [en]

    Background: Research suggests that social status in school plays an important role in the social lives of adolescents and that their social status is associated with their health. Additional knowledge about adolescents’ understanding of social hierarchies could help to explain inequalities in adolescents’ health and guide public health interventions.

    Objective: The study aimed to explore what contributes to subjective social status in school and the strategies used for social positioning.

    Methods: A qualitative research design with think-aloud interviews was used. The study included 57 adolescents in lower (7th grade) and upper secondary school (12th grade) in Sweden. Subjective social status was explored using a slightly modified version of the MacArthur Scale of Subjective Social Status in school. Data were analyzed using thematic network analysis.

    Results: The participants were highly aware of their social status in school. Elements tied to gender, age, ethnicity and parental economy influenced their preconditions in the positioning. In addition, expectations on how to look, act and interact, influenced the pursue for social desirability. The way these different factors intersected and had to be balanced suggests that social positioning in school is complex and multifaceted.

    Conclusions: Because the norms that guided social positioning left little room for diversity, the possible negative impact of status hierarchies on adolescents’ health needs to be considered. In school interventions, we suggest that norms on e.g. gender and ethnicity need to be addressed and problematized from an intersectional approach.

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  • 30. Jordal, Malin
    et al.
    Essen, Birgitta
    Wijewardena, Kumudu
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Olsson, Pia
    Migrant Women Negotiating Gender Relations and Sexual and Reproductive Health Risks in Free Trade Zones, Sri Lanka2012In: International Journal of Qualitative Methods, E-ISSN 1609-4069, Vol. 11, no 5, p. 861-862Article in journal (Other academic)
  • 31.
    Jordal, Malin
    et al.
    Uppsala University.
    Essén, Birgitta
    Uppsala University.
    Wijewardena, Kumudu
    University of Sri Jayawardenapura.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Olsson, Pia
    Uppsala University.
    Migrant women negotiating gender relations and sexual and reproductive health risks in Free Trade Zones, Sri Lanka2012In: International Journal of Qualitative Methods, E-ISSN 1609-4069, Vol. 11, no 5, p. 861-862Article in journal (Refereed)
  • 32. Jordal, Malin
    et al.
    Essén, Birgitta
    Wijewardena, Kumudu
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Olsson, Pia
    Negotiating Respectability: Migrant Women Workers' Perceptions on Relationships and Sexuality in Free Trade Zones in Sri Lanka2014In: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 35, no 6, p. 658-676Article in journal (Refereed)
    Abstract [en]

    Migration has implication for women's sexual and reproductive health and rights. Our purpose with this study was to explore unmarried migrant women's perception on relationships and sexuality in the context of Sri Lankan Free Trade Zones. Sixteen semi-structured qualitative interviews were analysed using thematic analysis. We found that the women's perceptions were influenced by gendered hegemonic notions of respectability and virginity. Complex gender relations both worked in favour of, and against, women's sexual and reproductive health and rights. Programs for improvement of migrant women's health should be informed by contextualised analysis of gender relations with its various dimensions and levels.

  • 33. Jordal, Malin
    et al.
    Wijewardena, Kumudu
    Öhman, Ann
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Essén, Birgitta
    Olsson, Pia
    'Disrespectful men, disrespectable women': men's perceptions on heterosexual relationships and premarital sex in a Sri Lankan Free Trade Zone - a qualitative interview study2015In: BMC International Health and Human Rights, E-ISSN 1472-698X, Vol. 15, article id 3Article in journal (Refereed)
    Abstract [en]

    Background: Gender norms have been challenged by unmarried rural women's migration for employment to urban Sri Lankan Free Trade Zones (FTZ). Men are described as looking for sexual experiences among the women workers, who are then accused of engaging in premarital sex, something seen as taboo in this context. Increased sexual and reproductive health and rights (SRHR) risks for women workers are reported. To improve SRHR it is important to understand the existing gender ideals that shape these behaviours. This qualitative study explores men's perspectives on gender relations in an urban Sri Lankan FTZ, with a focus on heterosexual relationships and premarital sex. Further, possible implications for SRHR of women workers in FTZs are discussed. Methods: Eighteen qualitative semi-structured interviews were conducted with men living or working in an urban Sri Lankan FTZ and were analysed using thematic analysis. Results: Two conflicting constructions of masculinity; the 'disrespectful womaniser' and the 'respectful partner', were discerned. The 'disrespectful womaniser' was perceived to be predominant and was considered immoral while the 'respectful partner' was considered to be less prevalent, but was seen as morally upright. The migrant women workers' moral values upon arrival to the FTZ were perceived to deteriorate with time spent in the FTZ. Heterosexual relationships and premarital sex were seen as common, however, ideals of female respectability and secrecy around premarital sex were perceived to jeopardize contraceptive use and thus counteract SRHR. Conclusion: The 'disrespectful' masculinity revealed in the FTZ is reflective of the patriarchal Sri Lankan society that enables men's entitlement and sexual domination over women. Deterioration of men's economic power and increase of women's economic and social independence may also be important aspects contributing to men's antagonistic attitudes towards women. The promotion of negative attitudes towards women is normalized through masculine peer pressure. This and ambivalence towards women's premarital sex are undermining the SRHR and well-being of women, but also men, in the FTZ. Awareness and counteraction of destructive gender power relations are essential for the improvement of the SRHR of women and men in the FTZ and the surrounding society.

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  • 34. Jordal, Malin
    et al.
    Öhman, Ann
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Wijewardene, Kumudu
    Respectability and rights: Sexual and reproductive health and rights of Sri Lankan women formerly involved in prostitution2020In: Contemporary South Asia, ISSN 0958-4935, E-ISSN 1469-364X, Vol. 28, no 1, p. 28-42Article in journal (Refereed)
    Abstract [en]

    Women in prostitution are often disrespected and subject to health risks. The aim of this study is to explore how women formerly engaged in prostitution in Sri Lanka position themselves in relation to gendered norms of respectability, and to discuss the possible implications for their sexual and reproductive health and rights (SRHR). Semi-structured qualitative interviews were conducted with fifteen women formerly engaged in prostitution. Discourse analysis was used to identify and describe interpretative repertoires and four repertoires were identified: Victimhood, Resistance, Responsibility, and Independence. The first three were drawn upon to construct their identities in line with norms of female respectability, as the women emphasised being victims of unfortunate situations, resisting sexual disrespectability and taking responsibility for their children and others. The last repertoire deviated from the respectability norm as it conveyed a picture of the women as independent, strong and courageous subjects, characteristics more in line with male respectability in Sri Lanka. Despite marginalised and oppressive circumstances, the women drew on interpretative repertoires to enhance access to respect, dignity and resources. However, their vulnerability to violence, SRHR risks and virtual absence of rights leave them with little access to resources that could enable a healthier and better life.

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  • 35.
    Kalman, Hildur
    et al.
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå University, Faculty of Social Sciences, Department of Social Work.
    Lundgren, Britta
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå University, Faculty of Arts, Department of culture and media studies.
    Öhman, Ann
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Challenges to Interdisciplinarity: Development of Arena Work in Gender Research Collaborations2012In: International Journal of Humanities and Social Science, ISSN 2220-8488, E-ISSN 2221-0989, Vol. 2, no 13, p. 58-67Article in journal (Refereed)
    Abstract [en]

    The article discusses the challenges of working with hybrid teams within the overarching programme ChallengingGender, with its interdisciplinary theme groups and its arena for joint reflection and theoretical development. Theintellectual exchange over concepts with heterogeneous meanings across hybrid themes may lead to manydebates and controversies over allegedly joint concepts and be experienced as time-consuming exercises that givemeagre results. The article analyses the interaction within hybrid themes and between themes on the arena. Theanticipated dynamics in the process of arena work required both flexibility and adaptability, and the work wasdeveloped in several stages. Two important steps were the outlining of core statements and core questions at theheart of each theme, and letting themes actively challenge the research questions of other themes. The articlestresses the importance of exposure to methodological and theoretical pluralism to create scientific developmentand intellectual excitement.

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  • 36.
    Keisu, Britt-Inger
    et al.
    Umeå University, Faculty of Social Sciences, Department of Sociology. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Öhman, Ann
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Enberg, Birgit
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Employee effort: reward balance and first-level manager transformational leadership within elderly care2018In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 1, p. 407-416Article in journal (Refereed)
    Abstract [en]

    Background: Negative aspects, staff dissatisfaction and problems related to internal organisational factors of working in elderly care are well-known and documented. Much less is known about positive aspects of working in elderly care, and therefore, this study focuses on such positive factors in Swedish elderly care. We combined two theoretical models, the effort–reward imbalance model and the Transformational Leadership Style model. The aim was to estimate the potential associations between employee-perceived transformational leadership style of their managers, and employees' ratings of effort and reward within elderly care work.

    Methods: The article is based on questionnaires distributed at on-site visits to registered nurses, occupational therapists, physiotherapists (high-level education) and assistant nurses (low-level education) in nine Swedish elderly care facilities. In order to grasp the positive factors of work in elderly care, we focused on balance at work, rather than imbalance.

    Results: We found a significant association between employees' effort–reward balance at work and a transformational leadership style among managers. An association was also found between employees' level of education and their assessments of the first-level managers.

    Conclusions: We conclude that the first-level manager is an important actor for achieving a good workplace within elderly care, since she/he influences employees' psychosocial working environment. We also conclude that there are differences and inequalities, in terms of well-being, effort and reward at the work place, between those with academic training and those without, in that the former group to a higher degree evaluated their first-level manager to perform a transformational leadership style, which in turn is beneficial for their psychosocial work environment. Consequently, this (re)-produce inequalities in terms of well-being, effort and reward among the employees at the work place.

  • 37.
    Keisu, Britt-Inger
    et al.
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Öhman, Ann
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Enberg, Birgit
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    What is a good workplace?: Tracing the logics of NPM among managers and professionals in Swedish elderly care2016In: Nordic Journal of Working Life Studies, E-ISSN 2245-0157, Vol. 6, p. 27-46Article in journal (Refereed)
    Abstract [en]

    Neoliberal policies such as new public management (NPM) have been pivotal to the Swedish elderly care system for two decades. This article explores the discourses of NPM and work by focusing on how a good workplace is represented by professionals and managers in Swedish elderly care. Using qualitative interviews with 31 managers, nurses, physiotherapists, and occupational therapists at nine workplaces, we identified four competing meanings (“storylines”) of how a good workplace is constructed among the interviewees within an ongoing struggle between two discourses. Three storylines, i.e., striving to achieve the mission, a desire to work in elderly care, and striving for good working relationships, are linked to the neoliberal discourse of organizational effectiveness. In contrast, the fourth storyline, support and better working conditions, is related to a welfare-state discourse of traditional labor relations with strong historical roots. Four subject positions available to the managers and professionals were identified: the bureaucrat, the passionate, the professional, and the critic. We conclude that NPM is translated on top of existing discourses, such as those of traditional labor relations, care ideals, and practices, that are already established in elderly care workplaces and that counteract the new policy.

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  • 38. Lindelow-Berntson, I
    et al.
    Gunnarsson-Routhledge, Z
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Sjukgymnastik, en del av livet. En kvalitativ studie av tre rörelsehindrade ungdomars uppfattningar om sjukgymnastik.1998In: Nordisk fysioterapi, ISSN 1402-3024, Vol. 2, p. 174-182Article in journal (Refereed)
  • 39. Lindgren, S
    et al.
    Frölander, N
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Ensamma i en diffus tillvaro: en kvalitativ pilotstudie om distriktssjukgymnasters psykosociala arbetsmiljö2001In: Nordisk fysioterapi, ISSN 1402-3024, Vol. 2, p. 84-91Article in journal (Refereed)
  • 40.
    Lundgren, Britta
    et al.
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Kalman, Hildur
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Öhman, Ann
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Bränström Öhman, Annelie
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Inledning2020In: Möjligheter och mellanrum: Berättelser om genus och akademiska livslopp, Stockholm: Makadam Förlag, 2020, 1, p. 7-18Chapter in book (Other academic)
  • 41.
    Lundgren, Britta
    et al.
    Umeå University, Faculty of Arts, Department of culture and media studies.
    Kalman, Hildur
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Öhman, Ann
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Bränström Öhman, Annelie
    Umeå University, Faculty of Arts, Department of culture and media studies. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Möjligheter och mellanrum: berättelser om genus och akademiska livslopp2020Book (Other academic)
  • 42.
    Lundqvist, Gunnar
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Sandström, Herbert
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Weinehall, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Patterns of tobacco use: a 10-year follow-up study of smoking and snus habits in a middle-aged Swedish population2009In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 37, no 2, p. 161-167Article in journal (Refereed)
    Abstract [en]

    Aims: To study longitudinal patterns of tobacco use over a 10-year period among middle-aged men and women in Västerbotten County, Northern Sweden.

    Methods: The study is based on data from the 16,486 (8800 women and 7686 men) in the Västerbotten Intervention Programme (VIP) where people were invited to a health screening and counselling programme at 30, 40, 50 and 60 years of age.

    Results: Smoking decreased from 22.3% to 15.6% among women and from 18.5% to 12.7% among men. Use of snus (Swedish moist snuff) increased from 3.1% to 6.0% among women and from 24.6% to 26.3% among men. The number of people who used both snus and cigarettes was stable: 0.5% to 0.8% from baseline to follow-up for women, and 4.1% to 3.3% for men. The number of tobacco-free adults increased from 75.2% to 79.2% for women and from 61.1% to 64.3% for men. Of those who became smoke-free during the 10-year follow-up period, 80% of the women and 66% of the men quit smoking without transitioning to snus use.

    Conclusions: The majority of middle-aged Swedish men and women in this cohort that quit smoking did so without becoming snus dependent. In spite of an increasing use of snus, overall there was a decline in the number of people using tobacco products.

  • 43.
    Lundqvist, Gunnar
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Weinehall, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Sandström, H.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    To be successful in smoking cessation, a study of 908 ex-smokers experiencesManuscript (preprint) (Other academic)
  • 44.
    Lundqvist, Gunnar
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Weinehall, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Sandström, Herbert
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Smokers becoming tobacco-free: a study of success factors among 513 middle aged smoking Swedes, who quit tobaccoManuscript (preprint) (Other academic)
  • 45.
    Lundqvist, Gunnar
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Weinehall, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Attitudes and barriers towards smoking cessation among middle aged and elderly women: a qualitative study in family practice2007In: The Internet Journal of Health, Vol. 5, no 2, p. 1-10Article in journal (Refereed)
  • 46. Löfgren, Monika
    et al.
    Ekholm, Jan
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    'A constant struggle': successful strategies of women in work despite fibromyalgia.2006In: Disabil Rehabil, ISSN 0963-8288, Vol. 28, no 7, p. 447-55Article in journal (Refereed)
  • 47. Månsdotter, Anna
    et al.
    Lindholm, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Lundberg, Michael
    Winkvist, Anna
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Parental share in public and domestic spheres: a population study on gender equality, death, and sickness.2006In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 60, no 7, p. 616-620Article in journal (Refereed)
  • 48.
    Månsdotter, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Lindholm, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Women, men and public health - how the choice of normative theory affects resource allocation.2004In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 69, no 3, p. 351-364Article in journal (Refereed)
  • 49.
    Ng, Nawi
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Centre for Population Studies (CPS).
    Söderman, Kerstin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Norberg, Margareta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Centre for Population Studies (CPS).
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Increasing physical activity, but persisting social gaps among middle-aged people: trends in Northern Sweden from 1990 to 20072011In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 4, p. 6347-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Physical activity is identified as one important protective factor for chronic diseases. Physical activity surveillance is important in assessing healthy population behaviour over time. Many countries lack population trends on physical activity.

    OBJECTIVE: To present trends in physical activity levels in Västerbotten County, Sweden and to evaluate physical activity among women and men with various educational levels.

    METHODS: opulation-based cross-sectional and panel data from the Västerbotten Intervention Programme (VIP) during 1990-2007 were used. All individuals in Västerbotten County who turned 40, 50, or 60 years old were invited to their local primary health care for a health screening. Physical activity during commuting, recreational activities, physical exercise, and socio-demographic data were collected using a self-administered questionnaire. Respondents were categorised as sedentary, moderate physically active, or physically active.

    RESULTS: The prevalences of physically active behaviours increased from 16 to 24.2% among men and from 12.6 to 30.4% among women. Increases are observed in all educational groups, but gaps between educational groups widened recently. The level of sedentary behaviour was stable over the time period studied. The 10-year follow-up data show that the prevalences of physically active behaviours increased from 15.8 to 21.4% among men and 12.7 to 23.3% among women. However, 10.2% of men and 3.8% of women remained sedentary.

    CONCLUSION: Despite the promising evidence of increasing physical activity levels among the population in Västerbotten County, challenges remain for how to reduce the stable levels of sedentary behaviours in some subgroups. Persisting social gaps in physical activity levels should be addressed further. An exploration of people's views on engaging in physical activity and barriers to doing so will allow better formulation of targeted interventions within this population.

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  • 50.
    Ng, Nawi
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Weinehall, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    'If I don't smoke, I'm not a real man'--Indonesian teenage boys' views about smoking.2007In: Health Education Research, ISSN 0268-1153, E-ISSN 1465-3648, Vol. 22, no 6, p. 794-804Article in journal (Refereed)
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