Anu Katainen

Background: Low socioeconomic position (SEP) is linked to obesity in high- and upper-middle-income countries. However, individual views and experiences concerning weight management of people with low SEP and obesity have been largely ignored. This qualitative systematic review aimed to synthesize the current research evidence on weight management practices, views, and experiences of adults with low SEP and obesity. Methods: We systematically searched MEDLINE (Ovid), APA PsychINFO (Ovid), CINAHL (EBSCOhost), Scopus, Web of Science, the Finnish health sciences database MEDIC, Google Scholar, and ProQuest Dissertations and Theses. Two researchers performed the title and abstract screening, full-text screening, and critical appraisal. One researcher performed the data extraction, categorized the findings, and aggregated the categories into synthesized findings with careful consultation with the other researchers. We assessed confidence in the findings and included only unequivocal and credible findings in the synthesis. Results: We screened a total of 1098 records, resulting in the inclusion of 12 final studies. A meta-aggregative synthesis yielded 5 main themes, derived from 17 categories: (1) social living environments were experienced to both support and hinder weight management; (2) unfavorable living conditions, such as lack of financial resources and challenging working conditions, hampered weight management; (3) constructive and personalized advice and support for weight management were desired from health professionals, but they were not often received; (4) psychological, spiritual, and physical health aspects influenced and often served as motivators for weight management; and (5) transitions in life cycle, such as becoming a parent, posed challenges to weight management, but provided also chances to engage in healthy lifestyle habits. The confidence scores of the synthesized findings were low. Conclusions: The findings of this review highlight the needs and aspirations of people with low SEP and obesity regarding their weight management, related to their social and living environment and to services provided by healthcare professionals. The support provided for weight management should consider both individual- and community-level aspects, and policy actions should improve structural factors (e.g., access to services and obesity stigma) that hamper weight management among people with low SEP and obesity. Systematic review registration: PROSPERO CRD42023407938.

Aims: The study examines how key stakeholders sought to influence the outcome of Finland's 2018 Alcohol Act reform in the formal consultation rounds. Methods: Drawing on the Advocacy Coalition Framework, we analyzed 224 stakeholder statements to uncover competing belief systems and framing strategies regarding alcohol-related harm. Results: We identified and named two main advocacy coalitions according to their standpoints on the reform's liberalization aspirations: the Public Health Coalition advocated for maintaining restrictive regulation based on population-level evidence and the Total Consumption Model, and the Alcohol Industry Coalition promoted deregulation through individual-level framings of responsibility and selective use of evidence. Both coalitions pursued epistemic dominance by reinforcing their own credibility and challenging that of their opponents. Although the Public Health Coalition relied on established scientific consensus, the Alcohol Industry Coalition appropriated the language of evidence-based policymaking to legitimize liberalization, aligning with broader neoliberal and populist discourses that question expert authority. Despite the scientific coherence of the public health side, the reform advanced in favour of deregulation, reflecting a broader shift toward a new public health and harm paradigm, in which individual responsibility is emphasized. Conclusions: The analysis shows how competing belief systems and discursive strategies shape alcohol policy in contexts where scientific expertise is increasingly politicized. It highlights a need for public health advocates to adjust their strategies to this new reality.

The study examined how alcohol policy stakeholders use research evidence to influence legislation and how the role of evidence and scientific expertise has changed over the past three decades in parliamentary alcohol policy consultations in Finland. The data consisted of parliamentary committee hearings on the comprehensive Alcohol Act reforms of 1994 and 2017. The analysis focused on the statements made by experts representing corporate interests, non-governmental organisations and research. The findings indicate the growing importance of science in the ways alcohol policies are influenced during the final stages of the law-making process. Researchers are being heard more frequently, and referencing research evidence has become a significant part of the epistemic work by which various stakeholders in the alcohol policy domain attempt to influence decision-makers. However, the scientification of policy debate does not necessarily indicate an increasing authority of science in determining policy outcomes. The demand for evidence appears to signal a shift in discourse rather than a change in the practice of parliamentary decision-making. Moreover, the consolidation of the ideal of evidence-based policymaking seems to be accompanied by shifting ways in which scientific experts are used – trending towards a legitimising function and an interest-based orientation.

Sosiaalipolitiikka uudistuu usein yllättävissä ja lyhyissä kausissa, ”politiikkatoimien ikkunoissa”. Artikkelissa tutkimme tapaustutkimuksen keinoin sosiaalisen tulosrahoituksen eli niin sanotun tulosperusteisen rahoitussopimuksen (SIB) edistämisprosessia osana hyvinvointipalveluiden uudenlaistaorganisoimista. Tutkimuksessa hyödynnämme John Kingdonin monien virtausten (multiple streams) teoriaa. Aineistona ovat asiantuntijahaastattelut ja valtiopäiväasiakirjat. SIB-mallia alettiin edistää Suomessa henkilövetoisesti. Malli sai poliittista kannatusta yksittäisten toimijoiden aktiivisuuden, poliittisen tilanteen ja sattumanvaraisten tapahtumien kautta. Keskeinen sattuma sosiaalisen tulosrahoituksen edistämisessä oli vuoden 2015 pakolaiskriisi, jonka yhteydessä mallia päätettiin soveltaaturvapaikanhakijoiden integroimisessa. Pakolaiskriisi ja henkilösuhteiden kautta saatu poliittinen tuki SIB-mallille näyttäytyvät hetkellisenä politiikkatoimien ikkunana, jossa mallin käyttöönotto mahdollistui. Tutkimus korostaa henkilötason verkostojen merkitystä sosiaalipolitiikan muutoksessa.

Over recent decades, sickness absence due to common mental disorders has increased among young workers. The phenomenon is mostly understood on the basis of epidemiological research, and knowledge regarding the viewpoints of young workers themselves is lacking. Our study explored the explanations for mental health‐related sickness absence in the narrative accounts of young workers in high‐risk health and social care occupations. Semi‐structured narrative interviews were conducted with 23 Finnish young workers (aged 21–34), with self‐reported sickness absence related to common mental disorders over the previous year. Our analysis identified three narrative explanations for the onset of mental health problems leading to sick leave: work as the sole cause, work as an additional cause and work as a trigger. These findings indicate that mental health‐related sickness absences form a complex phenomenon related to various life and work‐related circumstances. More comprehensive preventive measures are needed in the health and social care sector to help tackle mental health problems among young workers.

Objective: The objective of this review is to synthesize the best available qualitative evidence on the weight management practices, views, and experiences of adults living with poor socioeconomic circumstances and obesity. Additionally, the review aims to deepen our understanding of the common narratives of obesity according to these people. Introduction: People living with poor socioeconomic circumstances are at increased risk of obesity, particularly in high-income countries, and their weight management practices (eg, weight-related behaviors) tend to be less healthy. Since prior research on socioeconomic inequalities in obesity is mostly from quantitative studies, the individual views and experiences related to weight management have been largely ignored. Thus, systematic qualitative evidence is needed on the weight management practices, views, and experiences of adults living with poor socioeconomic circumstances and obesity. Inclusion criteria: Qualitative studies examining adults (aged 18 to 74 years) living with poor socioeconomic circumstances and obesity, and conducted in high- and upper-middle-income countries will be considered. The phenomenon of interest is these people’s weight management practices, views, and experiences. Methods: Searches will be conducted in MEDLINE (Ovid), APA PsycINFO (Ovid), CINAHL (EBSCOhost), Scopus, Web of Science, and the Finnish health sciences database, MEDIC, restricted to the English and Finnish languages. Sources of unpublished studies and gray literature will include Google Scholar and ProQuest Dissertations and Theses. Two independent reviewers will screen the papers, assess methodological quality, and extract data following JBI’s procedures. The meta-aggregative approach will be used for data synthesis. Confidence in the findings will be assessed using the ConQual approach. Review registration: PROSPERO CRD42023407938

Unhealthy behaviours are more prevalent in lower than in higher socioeconomic groups. Sociological attempts to explain the socioeconomic patterning of health-related behaviour typically draw on practice theories, as well as on the concept of lifestyles. When accounting for “sticky” habits and social structures, studies often ignore individuals’ capacity for reflection. The opposite is also true: research on individual-level factors has difficulty with the social determinants of behaviour. We argue that the pragmatist concept of habit is not only a precursor to practice theories but also offers a dynamic and action-oriented understanding of the mechanisms that “recruit” individuals to health-related practices. In pragmatism, habits are not merely repetitive behaviours, but creative solutions to problems confronted in everyday life and reflect individuals’ relationships to the material and social world around them. Ideally, the pragmatist conception of habits lays the theoretical ground for efficient prevention of and effective support for behaviour change.

People should be able to quit or moderate their drinking without negative social consequences, but studies have shown how nondrinkers often face pressure and negative reactions. As previous researc...