Norwegian society is multicultural and diverse with many immigrants especially from Southeast Asia (Kale, 2006).

In the coming years there is expected to be an increase in needy elderly people with immigrant background requiring health care. This will present considerable challenges to those working in the Norwegian health care sector (Meld.St.29, 2013).

At the same time the World Health Organization predicts an increase, on a worldwide scale, in lifestyle diseases such as diabetes type II (T2D).  Further research also shows that the prevalence of T2D among Southeast Asian women is higher than in ethnic Europeans (Glenday, Kumar, Tverdal & Meyer, 2006). Many of these immigrant women, in Norway, are presently receiving treatment for T2D from primary health care services and will be in need of such help also in the future. As T2D requires life-style changes on part of the patient, as well as treatment, the Ministry of Health in Norway sees this as a particular health challenge for the health sector in the future.

There will be increased focus, within the health sector, on multiculturalism and health issues within minority-groups with emphasis on communication and cultural understanding (Kumar, Oppedal, Bystad, Dalgard & Vangen, 2010). This will, in turn, influence the content in both health education and vocational practices in the future (Kale, 2006). Upper secondary schools have a responsibility to include multiculturalism and its impact and relevance on working life in their teaching (Meld.St.28 (2015-2016 p. 13). The largest group with formal education within the health sector are educated, in the upper secondary school educational system, to be “registered health -care workers”. It is important that these pupils acquire the knowledge and understanding of multiculturalism and its related health issues. so ensuring that the health sector can meet the challenges it faces in the future.

However vocational student teachers in health and social studies at OsloMet, have expressed that they have limited knowledge about challenges in dealing with multicultural health and social issues. This has consequence for facilitation of this knowledge in their future roles as teachers of health-care workers in upper secondary schools.

To increase knowledge and skills in dealing with these aspects it is important that vocational teachers are familiar with different health behavioural models, for example Prochaska and DiClemte's trans- theoretical stage model (1983) and Antonovsky's  Sence  of Coherense (1987).

Prochaska & DiClemente (1983) have developed a trans-theoretical model often used in health change behaviour. This model has five stages which describe the process for helping for example immigrant women with lifestyle changes. Antonovsky's (1987) focuses on patients' using their own resources to enable health changes. This requires that the patient has the capacity and opportunity to initiate health changes.

Research questions

What challenges are experienced by Southeast Asian immigrant women diagnosed with T2D, in the Norwegian health care sector?

What measures are introduced to ensure that the women achieve dietary change and increased physical activity?

Method: The study is conducted in Oslo and includes six semi-structured interviews undertaken with first generation immigrant women, aged 55 upwards, from Southeast Asia. A health visitor, working at a health centre, helped in the selection of informants. All interviews were conducted with a female interpreter present, as requested by the informants Two semi-structured interviews were also conducted, one with a health visitor and one with a relative of one of the women. After each interview, reflection notes were written, which form part of the data used in the analysis. A structured literature search in Cocraine and Oria was conducted. This gave 84 relevant articles of which 20 are included in this study. Semi structured interviews and data gained from the literature search were analysed using a phenomenological approach (Patton, 2015).

Result Our preliminary results indicate that health- care workers feel they do not have adequate competence in immigrants’ health challenges to recommend life-style changes. Immigrant women diagnosed with T2D expressed being anxious and frightened due to their lack of knowledge and understanding of the disease. It was difficult to ascertain if information from health-care workers was actually given or if it was just not understood by the women. The findings show that knowledge and competence in multiculturalism needs to be given much more focuses both in vocational teacher education and vocational education in upper secondary schools.

Antonovsky, A. (1987). Unraveling The Mystery of Health: How People Manage Stress and Stay Well. San Francisco: Jossey-Bass Publishers. Kale, E. (2006). „Vi tar det vi har”: Om bruk av tolk i helsevesenet i Oslo: En spørreskjemaundersøkelse (NAKMIs skriftserie om minoriteter og helse 2/2006). Oslo: Nasjonal kompetansesenter for minoriteter. Kumar, B., Oppedal, B., Blystad, H., Dalgard, S. & Vangen, S. (2010). Helse blant flyktninger og innvandrere. I E. K. Grøholt, L. Grøtvedt, H. Hånes &, G. Stene-Larsen (Red.), Folkehelserapport 2010: Helsetilstanden i Norge. Oslo: Nasjonalt folkehelseinstitutt. Glenday, K., Kumar, B., Tverdal, A. A. & Meyer, H. (2006). Cardiovascular disease risk factors among five ethnic groups in Oslo, Norway: The Oslo Immigrant Health Study. European Journal of Cardiovascular Prevention and Rehabilitation, 13(3), 348-355. doi:10.1097/01.hjr.0000214616.14361.51 Meld. St. 28 (2015-2016). (2016). Fag – Fordypning – Forståelse — En fornyelse av Kunnskapsløftet.Oslo: Kunnskapsdepartementet Meld. St. 29 (2012-2013). (2013). Morgendagens omsorg. Oslo: Helse- og omsorgsdepartementet. NOU2014: 7 (2014). Elevenes læring i fremtidens skole — Et kunnskapsgrunnlag. Oslo: Kunnskapsdepartementet Patton, M. Q. (2015). Qualitative research & evaluation methods: Integrating theory and practice (4. utg.). Los Angeles: Sage Prochaska, J. O. & DiClemente, C. C. (1983). Stages and process of self-change of smoking: Toward an integrativ model of change. Journal of Counsulting and Clinical Psychology, 51(3), 390-395.