Abstract
Background
We evaluated a health promotion program (HPP) for unaccompanied minor asylum seekers (UMA) in the canton of Vaud, Switzerland. UMA are particularly vulnerable to a range of health issues, due to their age and migration experiences. Effective health promotion programs are key to empower them to overcome these challenges and to improve their health.
Methods
We adopted a qualitative design with ethnographic and participatory elements to identify strengths, opportunities for improvement and appropriateness as perceived by UMA, educators and nurses responsible for UMA health care and the HPP. Data collection included observation of HPP courses, focus group discussions with UMA and interviews with educators. Analysis was based on a grounded theory in ethnography approach.
Results
Finding include three main themes: 1) UMA’s perceived low power and control, due to predominant rules and regulations and uncertainty about the future; 2) A need for health promotion in this population, due to UMA’s risk behaviours and the educators’ perceived discomfort with health-related issues and health promotion; 3) Practical feedback regarding topics, teaching methods and HPP organisation. Main recommendations include using effective adolescent health education methods to improve the appropriateness to age and context, enhancing participation of educators in health promotion and improving practical aspects of the HPP.
Conclusions
We evaluated and documented health promotion practice in the hard to reach population of UMA. Feasible changes in teaching methods and multidisciplinary collaboration may improve the HPP. However, UMA’s social environment needs to be taken into consideration to provide effective health promotion programs.
Key messages
Unaccompanied minor asylum seeker and educators perceive the health promotion program as useful and important. To address the health promotion needs of UMA, any program must be adaptive to the contextual complexity of UMA lives.
Learning what matters for patients: qualitative evaluation of a health promotion program for those with serious mental illness
