Studio DöBra : creating spaces for engaging with end-of-life issues and interacting across generations through community-based arts activities

Background: Studio DöBra was a community-based arts initiative about dying, death, and loss, involving children (9 years old) and older adults (most 80+) as participants. The goals were to support community engagement with end-of-life (EoL) issues and create opportunities for interaction between children and older adults. Studio DöBra was developed and studied in a collaboration between academic and community partners as part of the Swedish DöBra research program. It was informed and motivated by the Swedish context with an aging population, an age-segregated society, and a lack of community-engagement in EoL-issues. In Studio DöBra a community-based health promotion approach to EoL-issues was applied, based on the idea that these issues can be of concern to everyone, regardless of age. A variety of different arts activities were used as EoL-issues may be difficult to put into words. Aim: The overall research aim is to investigate the processes and impacts of developing, facilitating, and participating in Studio DöBra. A secondary aim is to investigate the experiences of professionals developing and facilitating initiatives that share characteristics of Studio DöBra. Methods: Studio DöBra was developed and investigated in a community-based participatory action research (CBPAR) process, with qualitative data generated throughout. Two iterations were developed (2016 and 2017-18) in different cities in Sweden. As the academic partner, I worked in collaboration with different community-organizations, e.g., organizations for children, older adults, and artistic organizations. Each iteration involved eight children and eight older adults in a series of five arts workshops addressing EoL-issues. Parallel to the first Studio DöBra iteration, I conducted exploratory interviews with professionals with experience from seven different initiatives that share characteristics of Studio DöBra. In 2018-19, together with community-partners from both iterations, we developed the Studio DöBra Toolbox, to document and disseminate findings to the general public; anchor lessons learned with management and local politicians; and inspire others to develop similar initiatives. This thesis is based on four articles. In Article I, the collaborative process of developing community-based intergenerational arts initiatives to engage communities in EoL-issues was investigated based on exploratory interviews from other projects and data from the first Studio DöBra iteration including follow-up interviews with community-partners. In Article II, follow-up interviews with older adults, children, and children’s parents were used to investigate how children and older adults motivate their participation, their experiences of participating, ways in which they were affected by participation, as well as how parents reflect on their child’s participation. Data analyses in articles I and II were guided by interpretive description. The aim of Article III was to explore mechanisms in arts activities that support community engagement with EoL-issues. An abductive analysis was carried out, using participant observation data from the arts workshops, follow-up interviews with participants and partners, and partners’ reflective meetings held in conjunction with each workshop, along with play theory. In Article IV, the aim was to investigate the impact of the Studio DöBra CBPAR process for partners, focusing on impact as both process and product. This was done though framework analysis expanding on Banks et al.’s (2017) theory of co-impact, based on longitudinal data from Studio DöBra, spanning 4.5 years. Findings: In developing Studio DöBra and similar initiatives, partners navigated power dynamics among partners and between people of different ages (I, IV). Partners were conceptualized as the “adults-in-between” the children and older adults in age, with power over and a sense of responsibility for these two age-groups, which could lead partners to deliberately or unwittingly, facilitate or hinder participants’ engagement with EoL-issues (I). Furthermore, partners were all supported by their jobs to develop Studio DöBra and the other investigated initiatives, however, they had different mandates and degrees of self-determination, which informed roles and affected their sense of ownership (I, IV). Children’s and older adults’ personal EoL-experiences and perceived lack of intergenerational interactions appeared to inform their motivation and participation in Studio DöBra. Some older adults were motivated by a desire for social connections and activities to counteract an increasing feeling of loneliness. Parents were generally positive about their child’s participation. Children and older adults seemed to act as individuals with agency in bonding across generations and in creating spaces for engaging with EoL-issues, both in Studio DöBra and in their social networks. They also seemed to appreciate learning about the ways others reflected about EoL-issues in Studio DöBra. Some parents and older adults spoke of having learned that they can talk with children about these issues. Although participants expressed a desire to maintain new intergenerational connections, challenges which seemed to relate to a lack of agency hindered this. (III) Modified play theory was used to explain four mechanisms in arts activities that support intergenerational engagement with EoL-issues: 1) The creation of a “Studio DöBra magic circle”, i.e., the spatial and temporal boundary separating the Studio DöBra workshops from “ordinary life”, created a space for intergenerational engagement with EoL-issues. 2) When facilitating, the partners tried to balance restrictions and freedoms in the topics, processes, and products of the arts activities. Determining restrictions and freedoms seemed to provide partners with a sense of control. When restrictions and freedoms appeared to be well-balanced, participants were independent in both the arts activity and engaging with EoL-issues. 3) Partners and participants approached EoL-issues through imagination and real-life experiences to deal with the potentially sensitive, abstract, and personal nature of these issues. 4) After each Studio DöBra workshop series ended, there were indications of a continuing sense of community, as shared experiences and products from arts activities seemed to bond participants. (III) Through the Studio DöBra CBPAR process, a conceptual model was developed that distinguishes three types of impact, i.e., impact on individual and group development, actionoriented impact, and strategy-oriented impact. The model describes impact as process as these types of impact are reciprocally interrelated and evolve from each other. Impact for Studio DöBra partners included developing interest, confidence, and skills in relation to intergenerational interactions and engagement with EoL-issues through arts activities, which partners applied in various ways in their professional practices and social networks. Furthermore, the Studio DöBra Toolbox was used in efforts to anchor lessons learned at higher levels of power, and initiate spinoff projects. (IV) Conclusion: This thesis contributes to an understanding of ways in which community-based intergenerational arts initiatives can be developed and facilitated to engage communityorganizations, older adults, children, and their parents in EoL-issues and stimulate intergenerational interaction. It also adds insight into ways in which impact can be understood as both product and process in CBPAR, and particularly in Studio DöBra

An Ageless State of Mind

This thesis investigates the question: Can Experience Design be applied to create a perception shift from elderly as a burden to elderly as a resource for society? This is done by researching the social norms about ageing and the aged in Swedish society. To conduct this research I put together a focus group of 7 people with different professional backgrounds and ages ranging from 23 to 74. In four workshops I used design-led research methods to research these “mental models”. Using participatory theatre techniques we investigated the personal view of the ageing process. And through discussions and design thinking we articulated the often unspoken social norms. In the workshops we defined our current social norms regarding ageing as Aged Thinking. A counter philosophy was developed called Ageless Thinking. In order to create a change in mindset from Aged Thinking to Ageless Thinking a tool was developed called the Enticon. With this tool people can show what their focus is in life right now regardless of their chronological age. The Enticon was introduced at the Konstfack Spring Exhibition 2013 and also as a web based application

Dobben in het ruilverkavelingsgebied Twijzel-Buitenpost

In opdracht van Staatsbosbeheer Friesland afdeling natuurbehoud is een onderzoek uitgevoerd om gegevens te verzamelen omtrent het ontstaan, en het mogelijke beheer, van dobben in het ruilverkavelingsgebied Twijzel-Buitenpost. Het onderzoek is verricht aan drie dobben, te weten de Bootsma’s dobbe en twee naast elkaar gelegen dobben aan de Mounewei. De vraagstellingen van het onderzoek waren: 1a. Zijn deze drie dobben pingoruines? 1b. Is er een gemeenschappelijke ontstaansoorzaak te vinden voor deze drie dobben,en geldt deze ontstaansoorzaak mogelijkerwijs ook voor andere dobben in het gebied? 2. Hoe is de hydrologische situatie in en rond Bootsma's dobbe? Met behulp van grondboringen en pollenanalyses is getracht de eerste (de geologische) vraagstelling te beantwoorden. Voor het beantwoorden van de tweede ( de hydrologische) vraagstelling is er gebruik gemaakt van de gegevens van het geologische onderzoek, en zijn er o.m. grondwaterbuizen geplaatst. Ook zijn twee keer tijdens de meetperiode een aantal (grond)watermonsters chemisch geanalyseerd. Bootsma's dobbe en de zuidelijke dobbe aan de Mounewei blijken pingoruïnes te zijn. Waarschijnlijk is ook de noordelijke dobbe aan de Mounewei een pingoruïne. Dit kan geconcludeerd worden op grond van deformatiestructuren in de ringwal rond de dobben, de dieptes van de dobben(2-3 meter) en de ouderdom van de dobben (de dobben zijn ontstaan op de grens van het Pleniglaciaal en de Bölling, dwz. tussen 25.000 en 18.000 BP). Een mogelijke gemeenschappelijke ontstaansoorzaak zouden beekbeddingen geweest kunnen zijn. Er zijn namelijk tussen twee dobben aan de Mounewei afzettingen gevonden die mogelijkerwijs duiden op een beekje dat daar gestroomd heeft. In hoeverre deze beekbeddingtheorie voor andere pingoruïnes in het gebied opgaat is moeilijk te zeggen. Indien andere dobben in het gebied ook (voor een groot deel) als pingo's in beekbeddingen zijn ontstaan kunnen een aantal aparte systemen (=fossiele beekbeddingen) onderscheiden worden. Uit het hydrologisch onderzoek blijkt dat Bootsma's dobbe vrij geïsoleerd ligt t.o.v. de omgeving. In de droge tijd van het jaar krijgt de dobbe slechts water aangevoerd via neerslag direct in de dobbe en mogelijkerwijs via overland flow. Dit laatste zal echter zeer zelden optreden. In de natte periode krijgt de dobbe daarnaast nog water oppervlakkig aangevoerd via sloten. De waterkwaliteit rond de dobbe blijkt te worden beïnvloed door het al dan niet voorkomen van keileem in de ondergrond, en daar min of meer aan gekoppeld de afstand tot de dobbe, en het perceel waaruit gemonsterd is. Binnen de dobbe blijkt de waterkwaliteit te worden beïnvloed door de drijftil die een groot deel van de dobbe bestrijkt en door de aanwezigheid van Cl-houdend veen in delen van de dobbe. De dobbe blijkt vrij voedselrijk te zijn. Dit moet zijn veroorzaakt door oppervlakkige aanvoer van voedselrijk water in de natte periode. Indien men wil verhinderen dat Bootsma's dobbe geheel dichtgroeit, moet worden getracht de aanvoer van dit voedselrijke water tegen te gaan.

Death, loss and community : Perspectives from children, their parents and older adults on intergenerational community-based arts initiatives in Sweden

Studio DoBra is a community-based initiative in which children (9 y/o) and older adults (mostly 80+) engaged with topics related to dying, death and loss through shared arts activities (e.g. collage, sculpture, games). In an ageing society, Sweden's end-of-life (EoL) care is increasingly professionalised and specialised, but there is little community involvement. One goal of Studio DoBra was therefore to support community engagement with EoL-related topics. Another goal was to create opportunities for interaction between children and older adults as there are few intergenerational meeting places. Two iterations of Studio DoBra were developed (2016, 2018) in different Swedish cities, utilising a community-based participatory research approach. Project groups comprised first author MK and representatives of community organisations such as meeting places for older adults, after-school centres and artistic organisations. Each iteration engaged eight children and eight older adults in a series of five workshops. This article investigates how children and older adults motivate their participation, their experiences of participating and ways in which they were affected by participation. We also investigate how parents reflect on their child's participation in Studio DoBra. Older adults, children and their parents were interviewed after each Studio DoBra. An inductive qualitative process guided by interpretive description was used to analyse the transcripts. Findings indicate that participants acted as individuals with agency in connecting across generations and in creating spaces for engaging with EoL-topics, not only in Studio DoBra but also in their social networks. Participants reflected on a changing sense of community through new intergenerational connections and social activities, and expressed a desire to maintain these. However, participants indicated sustainability challenges related to lacking agency in maintaining these spaces and sense of intergenerational community, as they rely on support from community organisations

Investigating Peer Advisors’ Strategies to Promote Cancer Prevention and Early Detection in Swedish Communities with Challenging Socioeconomic Conditions

Worse socioeconomic conditions (e.g., having a migration background, lower income, and lower educational level) may lead to barriers for cancer prevention and early detection. Community-based initiatives providing tailored and accessible information are found to increase cancer screening participation and improve health outcomes for people with challenging socioeconomic conditions. To inform such initiatives, more research is needed from the perspective of those working with them. This article focuses on the Swedish “peer advisor project” in which the Regional Cancer Centre Stockholm Gotland (RCC) collaborates with community-based peer advisors to reduce cancer inequities in areas with challenging socioeconomic conditions. We aim to investigate the perspectives of people working with the peer advisor project in relation to challenges they face, strategies they use, and forms of impact they perceive their work to have. We used a participatory action research approach, involving 12 peer advisor representatives and three RCC representatives. Underlying data (interviews and participant observations) were qualitatively analyzed. Findings are presented in relation to three themes: (1) Peer advisors bridge a gap between the cancer care system and communities through dialogues with communities and RCC representatives. (2) Peer advisors navigate culturally based sensitivities through efforts to create safe spaces for discussing cancer prevention and early detection. (3) Peer advisor and RCC representatives described forms of impact in relation to personal contexts, community contexts, RCC’s organizational context, and societal context. Sustainability and structural challenges may limit the peer advisor project to create impact. We discuss that peer advisors may act as cultural brokers through dialogues with communities and the cancer care system, thereby increasing an understanding of communities’ contexts and needs. Findings from this study can inform development and implementation of similar community-based peer-to-peer initiatives in other contexts. More research is needed to investigate the long-term impact of the project including community-based perspectives