This thesis investigates how body positivity and sustainability are discursively constructed by fast fashion brands. The brand chosen as a case study is H&M, as it describes itself as being both environmentally and socially involved. Yet, despite H&M's claims, during our preliminary research we were able to detect the lack of accessibility of sustainable collections to plus size customers. In this essay, we analyze how H&M communicates body inclusivity in its sustainability reports, website, and YouTube campaigns promoting conscious lines. Drawing on theories of representation, biopolitics, and post-feminism, we sought to critically analyze the previously mentioned material through a multimodal critical analysis. The results show how H&M discursively constructs health communication in different ways depending on which clothing line the brand is promoting and to which consumers it is being advertised. Class discourses were recognized, leading to exclusive access to sustainable clothing for higher income shoppers. We believe this work is relevant to opening up the discussion about democratization and making sustainable items fully accessible to everyone.

Introduktion: Hälso- och sjukvården blir allt mer digitaliserad, där e-hälsa och digital hälsokommunikation förväntas kunna bidra till bättre hälsa för befolkningen. Det är viktigt att vårdens professioner är uppdaterade och delaktiga i utvecklingen för att möta medborgarnas ökade förväntningar och behov. Tidigare studier har visat att attityd och kunskap kan utgöra barriärer för implementering av digitala verktyg. Syfte: Syftet var att undersöka rådgivande sjuksköterskors upplevelser av möjligheter och utmaningar med digitalisering och digital hälsokommunikation inom den egna yrkesrollen och organisationen. Frågeställningarna berörde digitalisering, digital hälsokommunikation och organisatoriskt stöd. Metod: Studien genomfördes som en kvalitativ intervjustudie med kvalitativ manifest innehållsanalys som analysmetod. Intervjuer gjordes med sju sjuksköterskor som arbetade inom ett specifikt verksamhetsområde och mötte patienter genom rådgivning på distans. Resultat: Resultatet visade att det är viktigt för sjuksköterskorna att känna sig uppdaterade i den digitala utvecklingen. Digitaliseringen påverkar arbetsrollen och ställer höga krav på digital kunskap. Digitala verktyg möjliggör säkrare och tryggare medicinsk rådgivning men parallella kommunikationsvägar är nödvändiga för att inte exkludera vissa grupper. Utmaningar och möjligheter med digitala vårdmöten handlade huvudsakligen om tillgänglighet, informationsåtkomst, arbetsmiljö och patientsäkerhet. För att uppleva organisatoriskt stöd i arbetet behöver sjuksköterskorna utbildning och delaktighet i digitaliseringsprocesser. Slutsats: Samspelet mellan teknik, människa och miljö är komplext. Det finns en vinst för verksamheter att inkludera sjuksköterskorna i digitaliseringsarbetet genom utbildning och stöd för att stärka sjuksköterskornas digital literacy för att uppnå en digital professionalism. Detta skapar goda förutsättningar för att i den digitaliserade hälso- och sjukvården främja patienters hälsa och möjligheter till ett gott liv. / Introduction: Digitalization is influencing health care, where eHealth and digital health communication are expected to contribute to better health for the population. It’s important that nurses are involved with digitalization in order to meet patients' increased expectations and needs. Previous studies have shown that attitude and knowledge can be barriers to implementation of digital technology. Aim: The aim was to investigate nurses’ perceptions of opportunities and challenges that come with digitalization and digital health communication, within their own professional role and organization. The research questions covered topics about digitalization, digital health communication and organizational support. Methods: The study was conducted as a qualitative interview study with qualitative manifest content analysis as an analysis method. Seven nurses in a specific area of health care were interviewed. Results: The result showed that the nurses want to be updated about the ongoing digitalization, and need a higher level of digital knowledge. Digital technology contributes to safe and secure medical consultations, though there is a need for parallel communication pathways to minimize the risk of digital exclusion. The challenges and opportunities with digital health communication referred to accessibility, information access, work environment and patient safety. Organizational support at work is related to education and being involved in digitalization processes. Conclusion: The interaction between technology, humans and environment is complex. There’s an opportunity for organizations to strengthen nurses’ digital literacy through education, participation and support towards a digital professionalism. Good conditions to meet people in a digitalized health care promote health and quality of life.

Background: The growing number of migrants, and refugees in particular, can have complex impacts on healthcare systems as they face pressures of responding to new healthcare needs. Refugees report lower levels of self-assessed health and psychological well-being compared to host populations, but paradoxically, many refrains from seeking care although they perceive the need to. Health promotion and improved health literacy has been identified to improve service utilization and health outcomes of refugees. Aim: Investigating perceptions of health communicators in implementing a Swedish version of the teach-back method for improved health information recall – Förstå Mig Rätt (FMR) – in the Swedish civic orientation for newly arrived refugees. Method: Semi-structured in-depth interviews were used to explore the utilization of FMR. Content analysis was used to analyze the data, and an integrated model for health literacy by Sørensen et al. guided the discussion in examining how FMR contributed to improved health literacy. Findings: Three themes emerged from the data: (i) Appreciating the impact of FMR; (ii) valuing the role of a communicator and; (iii) practical challenges of implementing FMR. The findings demonstrated an overall appreciation for the method but implicated changes in the layout for further improvements. Conclusion: FMR serves its purpose of ensuring recall and understanding of health information among newly arrived refugees attending the Swedish civic orientation. For optimal utilization, groups should be adjusted for participant educational level while further clarification on restating information, and extended time for dialogue, is recommended.

Antibiotic resistance is one of the greatest global threats we face today. Human overuse ofantibiotics is a contributing factor and major behaviour change around antibioticconsumption is needed, but several challenges exist in communicating antibiotic resistanceto the public. In 2018 the UK Government relaunched a national television advertisement aspart of the ‘Keep Antibiotics Working’ campaign which aimed to raise awareness of antibioticresistance and reduce public demand for antibiotics. This study evaluates what role theframing of antibiotic resistance in the advertisement played in increasing publicunderstanding of antibiotic resistance and motivating behaviour change. The study isgrounded in behaviour change and health communication theory from the field ofCommunication for Development, and health and social psychology theory, reflecting theneed for multidisciplinary approaches to addressing antibiotic resistance. A textual analysisidentified how the issue was framed in the advertisement and surveys and interviews wereconducted with members of the target audience groups to analyse what effect theadvertisement had on their understanding of, and attitude towards antibiotic resistance.The findings show that the framing of antibiotic resistance in the TV advertisement led to anincrease in misunderstandings of what becomes resistant to antibiotics. The advertisementwas helpful in highlighting the vulnerability of antibiotics and for creating a new social normaround being a responsible antibiotic user, however was interpreted as childish byparticipants. It did not communicate the severity of antibiotic resistance or specific risk ofantibiotic overuse to the audience, or accurately reflect the audience’s existing knowledge ofantibiotic resistance and current behaviours. As the severity of antibiotic resistance was notconveyed, the advertisement did not motivate a change in antibiotic seeking behaviours orattitude amongst the majority of participants. The findings did highlight knowledge gapsamongst study participants including the importance of completing a course of antibiotics asprescribed, and that it is the bacteria itself, not the person, that develops resistance, andhopes this research can inform the development of future campaigns.

Background: Shared decision-making (SDM) counseling for lung cancer screening is recommended by multiple professional societies and mandated by the Center for Medicare and Medicaid Services since lung cancer screening has both benefits and risks. However, uptake of SDM counseling as well as lung cancer screening itself remain low. We sought to develop educational text messages about lung cancer screening as an innovative implementation intervention tool to promote patient-provider discussion about lung cancer screening. Methods: After the study team drafted educational text messages about lung cancer screening, informed by existing decision aids, participants who had had lung cancer screening were recruited and asked to review and edit text messages. After that, participants eligible for lung cancer screening without the previous screening experience were recruited and were asked to select the messages to be included in this text message intervention. The final set of 14 text messages were delivered to the participants both with and without the previous lung cancer screening over a period of 14 days. Participants completed a telephone survey assessing their reactions to the messages after receiving the last message. Results: We successfully involved twelve participants with lung cancer screening experience and eleven lung cancer screening eligible participants without previous screening experience in the development of educational text messages about lung cancer screening. After one participant withdrew, 22 participants received text messages and completed the survey regarding the messages. Most participants (18 of 22) reported reading all 14 text messages, however most recommended sending fewer messages (median recommended number of messages = 10). Participants found the educational text messages informative. Only four participants reported the text messages triggered anxiety and two reported text messages disrupted their daily activities. Participants perceived the text messages would empower patients to discuss lung cancer screening with their providers. Conclusion: Participants generally supported the use of educational text messages about lung cancer screening to increase patients’ awareness and promote patient-provider discussion. Engaging patients in the development and evaluation of text messages elicited helpful feedback that will inform the content of the messages to be delivered via this lung cancer screening text messages intervention.

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Indoor tanning (IT) before the age of 35 increases one’s risk for melanoma by 75%, and epidemiological data show a 6.1% annual increase in the incidence of melanomas in white women younger than age 44 in the US. Population-based studies reveal that 15% of adolescents and 8% to 14% of their primary caregivers have engaged in IT in the past year. The compelling case for IT being a significant risk factor for melanoma, together with the high rates of IT in teen girls and their mothers, provided a strong rationale for conducting an antitanning intervention directed at mother-daughter dyads. This study evaluated a strategy designed to prevent skin cancer in adolescent girls by using mothers as change agents to effectively communicate the risks of IT and to encourage teens to avoid high risk IT behaviors. Mother-daughter dyads were recruited over the telephone, randomly assigned to the intervention or control group, and surveyed on IT risk constructs including tanning-specific knowledge and communication. Forty-two mother-daughter dyads completed baseline surveys in the summer of 2012. Mothers in the intervention group were given a handbook educating them on the dangers of IT and how to convey information about skin cancer prevention to their daughters and encouraged to talk with their daughters about the issues covered in the handbook over a 1-month period. Participants completed follow-up assessments in October 2012 and January 2013. Among teens, past 3-month IT frequency, intentions, and willingness decreased in intervention group teens, while intentions and willingness increased among control teens. Intervention teens exhibited lower IT attitudes and higher levels of perceived susceptibility to appearance damage and health effects from IT when compared to control teens. Intervention teens reported higher levels of maternal monitoring and lower levels of maternal permissiveness toward IT. Qualitative data indicated mothers responded positively to the handbook, and it encouraged tanning-specific discussions with their daughters. Mothers provided suggestions on how to improve the handbook, that once incorporated, should lead to improved intervention efficacy. Overall, study results indicated this intervention strategy is feasible, as mothers did communicate with their teens and were able to convey the antitanning messages.

Problematic substance use is a pressing global health problem, and dissemination and implementation of accurate health information regarding prevention, treatment, and recovery are vital. In many nations, especially the US, many people are involved in religious groups or faith communities, and this offers a potential route to positively affect health through health information dissemination in communities that may have limited health resources. Health information related to addiction will be used as the backdrop issue for this discussion, but many health arenas could be substituted. This article evaluates the utility of commonly used health communication theories for communicating health information about addiction in religious settings and identifies their shortcomings. A lack of trusting, equally contributing, bidirectional collaboration among representatives of the clinical/scientific community and religious/faith communities in the development and dissemination of health information is identified as a potential impediment to effectiveness. The Substance Abuse and Mental Health Services Administration's (SAMHSA) tenets of trauma-informed practice, although developed for one-on-one use with those who have experienced trauma or adversity, are presented as a much more broadly applicable framework to improve communication between groups such as organizations or communities. As an example, we focus on health communication within, with, and through religious groups and particularly within churches.

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