Search

ObjectivesSome migrant groups are disproportionately affected by key infectious diseases in European countries. These pose a challenge for healthcare systems providing care to these groups. We aimed to explore the views of general practitioners (GPs) on the acceptability, adaptability and feasibility of a multidisease screening programme based on an innovative clinical decision-support system for migrants (the ISMiHealth tool), by examining the current gaps in healthcare provision and areas of good practice and the usefulness and limitations of training in the health needs of migrants.MethodsWe undertook a qualitative descriptive study and carried out a series of focus groups (FGs) taking a pragmatic utilitarian approach. Participants were GPs from the four primary healthcare (PHC) centres in Catalonia, Spain, that piloted an intervention of the ISMiHealth tool. GPs were recruited using purposive and convenience sampling. FG discussions were transcribed and analysed using thematic content analysis.ResultsA total of 29 GPs participated in four FGs. Key themes identified were: (1) GPs found the ISMiHealth tool to be very useful for helping to identify specific health problems in migrants, although there are several additional barriers to screening as part of PHC, (2) the importance of considering cultural perspectives when caring for migrants, and of the impact of migration on mental health, (3) the important role of PHC in healthcare provision for migrants and (4) key proposals to improve screening of migrant populations. GPs also highlighted the urgent need, to shift to a more holistic and adequately resourced approach to healthcare in PHC.ConclusionsGPs supported a multidisease screening programme for migrant populations using the ISMiHealth tool, which aided clinical decision-making. However, intercultural participatory approaches will need to be adopted to address linguistic and cultural barriers to healthcare access that exist in migrant communities.

MyHealth European project (2017-2020) was committed to elaborate on models to engage vulnerable migrants and refugees (VMR) in their health through community involvement. Low healthcare access and poor quality of healthcare services for VMR is a common reality in many European countries. The purpose of the present study, as part of MyHealth project, was the development of an agenda for actions and consequent recommendations to tackle the issue. A qualitative research design was applied at four study sites in Barcelona, Spain; Berlin, Germany; Brno, Czech Republic and Athens, Greece. The Metaplan® group discussions allowed the collection, organization and process of ideas and opinions elaborated in the collaborative groups. In total, 14 sessions took place: 4 with health and social professionals (n = 41) and 10 with VMR (n = 77). A participatory thematic analysis was performed at every session and overall for all sessions a thematic analysis synthesized the findings. The suggested actions were divided into two levels of recommendations: (i) local authorities at destination country-related, such as the investment in health professionals' cultural competences, and (ii) VMR-related, such as adaptation of help-seeking behavior patterns. Special attention was proposed to women survivors of violence and homeless minors. The study concluded to an agenda for action in Europe. We advocate for a public health paradigm shift where, while holding a bottom-up approach, VMR as well as professionals working with them are actively and meaningfully engaged in the decision-making process of access-enhancing and health promotion strategies in a given socio-cultural context.Low healthcare access and poor quality of healthcare services for vulnerable migrants and refugees (VMR) is a common reality in many European countries. As part of MyHealth project (2017–2020), a qualitative methodology was used to engage VMR and professionals in the decision-making of proposed actions and corresponding recommendations to address the issue.

Objectives Distressing physical symptoms (e.g., back pain, nausea), many of which lack medical explanation, are a common cause for medical help seeking. However, racial/ethnic and educational differences may complicate identification and explanation of such symptoms, potentially contributing to clinician misdiagnosis and patient dissatisfaction. To better understand this issue, we examined racial/ethnic differences in general physical symptoms (GPS) and, more specifically, medically unexplained physical symptoms (MUPS) and whether differences varied by race/ethnicity and educational attainment. Method A sample of 4,864 Latino, Asian, and non-Latino White community respondents (54% female; average age of 41 years) self-reported their GPS. Two experts then rated whether endorsed symptoms were likely to have a medical basis. We assessed the associations of GPS and MUPS with race/ethnicity, age, gender, educational attainment, chronic physical conditions, and past-year psychiatric diagnoses. Results Asian respondents reported significantly fewer GPS than non-Latino Whites, and both Asian and Latino respondents endorsed significantly fewer MUPS than non-Latino Whites. When nativity and language were each included as covariates, racial/ethnic differences in GPS count were no longer observed; however, observed differences in MUPS count remained. Educational attainment did not demonstrate a significant relationship with either GPS or MUPS. Although comorbid mental health diagnoses were significantly related to both GPS and MUPS, age, gender, and comorbid physical conditions were the only significant predictors of GPS. Conclusions Results from this study question existing stereotypical views of racial/ethnic differences in somatization and suggest that educational attainment does not significantly contribute to reported physical symptoms-with or without medical explanation. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

La pandemia global de la COVID-19 y sus derivadas en la vida social, política y económica han intensificado algunas de las desigualdades y vulnerabilidades existentes, a la vez que han propiciado nuevas formas de vivir lo cotidiano, marcadas principalmente por el confinamiento. Nuestra investigación pretende analizar, desde el prisma de la antropología médica, los efectos emocionales y relacionales de la nueva situación y su evolución durante los próximos meses. Para ello hemos partido de la centralidad creciente que tienen las redes sociales y las nuevas tecnologías de comunicación en un contexto de distanciamiento social y/o físico. Nos hemos basado en estas tecnologías y en sus potencialidades metodológicas para recoger datos sobre las condiciones y los efectos del confinamiento y la crisis sanitaria. Con este objetivo, estamos recabando datos cualitativos y cuantitativos mediante un cuestionario online que combina preguntas abiertas con otras de elección múltiple. En este texto se presentan algunos resultados preliminares.

Atención sanitaria; Migrante; Encuesta Atenció sanitària; Migrant; Enquesta Healthcare; Migrant; Survey Heightened conflicts and lack of safety due to reasons related to economic, social, ethnic, religious, sexual orientation, political, or nationality matters have increased migratory movements during the last, few decades. Unfortunately, when migrants arrive in new territories, they can face many barriers. For example, in Spain, some migrants have difficulties in accessing health services. The main objective of this study was to describe, from the perspective of social and healthcare professionals, health needs and barriers faced among migrants who recently arrived in Spain when accessing the health system. To accomplish this aim, we carried out a cross-sectional descriptive study using a newly created self-administered questionnaire. Statistical analysis was done using the SPSS 23.00® program. Survey collection was from April 2018 to October 2018, and the cohort comprised a total of 228 professionals. Most participants were females (76%), with an average age of 35 years [interquartile range (IQR) 29.8–43.0]. The most represented profession in the cohort was physician (48%), followed by social care professionals (32%), nursing (11%), and other (8%). Of these individuals, 61% stated having either little or limited knowledge of international migrant health rights, and 94% believed migrants must overcome barriers to receive health services. The four most reported barriers were as follows: language, cultural differences, administrative issues, and fear of being undocumented. Additionally, by order of importance, professionals viewed mental health disorders and infectious diseases as the most common contributors to disease burden in this group. The four most popular strategies implemented by professionals to improve healthcare access further for migrants included intercultural competency training for professionals; access to community health agents; access to translators; and development of health system navigation skills among those newly arrived. Study results suggest that governments should make greater efforts to provide social and healthcare professionals with more effective tools that overcome communication barriers and cultural competence training modules. Research reported in this publication was supported by co-funding from the Third EU Health Program (2014-2020) Project Grants (HP-PJ-2016) under Grant Agreement 738091 (MyHealth Consortium).

Objective We present the results of a cross‐cultural validation of the Mental Health Global State (MHGS) scale for adults and adolescents (

Background Spain has been a popular destination for immigrants mainly because of its cultural proximity with Latin America and its geographical proximity with Africa. More than 70% of migrants in the Spanish autonomous region of Catalonia reside in its capital city, Barcelona. The community engagement in the development of tools, which facilitate access to health services while ensuring quality healthcare provision to Vulnerable Migrants and Refugees (VMRs), is pivotal in health promotion initiatives. Methods The participation of the target population in the decision-making process over strategies to increase healthcare access was assured by employing the Metaplan© methodology. Five Metaplan group sessions were conducted in Barcelona with VMR: One with professionals (N = 13), two with young adults (N = 4, N = 6), one with women (N = 6) and one with Latin Americans (N = 9). All sessions were conducted at the Community Medicine Unit of Vall d’Hebron University Hospital. Results Two main categories of solutions were found through a thematic analysis. Primarily, the solutions associated to initiatives that the host community needs to undertake included: promotion of socio-economic stability for VMRs, communication campaigns though informative leaflets and orientation sessions on immigrants’ rights and available health services, as well as community-based interventions such as empowering the work of community agents/“health champions”, establishing mobile clinics and setting-up (peer) support groups. The second category of solutions was related to the personal barriers VMRs may face: improvement/acquisition of language skills and the importance of addressing one’s mental health problems. Conclusions Both the host community and the immigrants themselves are co-authors of the design and implementation of efficient health promotion strategies towards healthcare access and improvement of healthcare quality provision for VMRs in the given socio-cultural context of Barcelona city.

The proposed workshop “Developing interventions to improve migrants’ healthcare access in Europe” will present interim results from the cross-disciplinary MyHealth project to discuss them and the early lessons with policymakers, academics, funders and practitioners in the area of migration and health. MyHealth (Models to engage migrants and refugees in their health, through community empowerment and learning alliance) is a three-year project coordinated by Fundació Hospital de la Vall d’Hebrón, Institut de Recerca (VHIR), Barcelona, Spain and implemented by a consortium of eleven partners with the CHAFEA support in the framework of the 3rd EU Health Program. The goal of the MyHealth project is to improve the healthcare access of vulnerable migrants and refugees (VMR) newly arrived to Europe, by developing and implementing models based on the knowhow of a European multidisciplinary network. This project strongly relies on a participatory approach to ensure a beneficiary-centred approach in implementing a number of interconnected objectives. To ensure a meaningful involvement of the community we applied the Metaplan technique to identify health concerns and needs perceived by vulnerable immigrants and also by professionals from diverse backgrounds working with them at the four partnering sites (Barcelona, Berlin, Brno and Athens). The Metaplan© is a qualitative technique that involves first collecting ideas or information on cards, grouping the cards according to shared characteristics, and ultimately, using a voting system to rank individual ideas or groups of ideas. The research team used this methodology to validate the health needs of immigrants identified by the MyHealth needs assessment methodology and prioritize them, and to generate, categorize and prioritize suggested solutions. These results will be analysed to identify community health strategies and to implement pilot interventions most relevant for the cultural and social reality at each of the sites. Further, the effectiveness of these interventions as a dissemination model will be evaluated. As an innovative approach, the project uses a Learning Alliance methodology to engage multiple stakeholders in the research process through a series of interconnected networks. Each of the he partners aim to document and reflect on best practices for the improvement of the migrants’ access to healthcare and thus provides an opportunity for mutual learning for the consortium members and their respective networks. The workshop will feature presentations by MyHealth partners that will be followed by the moderated Q&A session with the panel of presenters. The workshop participants feedback will be additionally sought through a self-administered workshop evaluation questionnaire. The workshop will facilitate the information exchange and discussion between the MyHealth consortium partners and other ongoing initiatives to improve migrants’ healthcare in European countries. Key messages The community engagement in the development of interventions to facilitate the access to health services while ensuring quality care to migrants community is pivotal in health promotion initiatives. In spite of the notable variability across the sites, the ubiquitous barriers were associated with both host and migrant communities, for which the future interventions would need to account.

The aim of the study was to provide an overview of the effect of exercise interventions on subjective quality of life (QoL) across adult clinical populations and well people, and to systematically investigate the impact of the exercise setting, intensity and type on these outcomes. From a systematic search of six electronic databases, 56 original studies were extracted, reporting on 7937 sick and well people. A meta-analysis was conducted on change in QoL from pre- to post-intervention compared with outcomes from a no-exercise control group, using weighted (by the study’s sample size) pooled mean effect sizes and a fixed-effects model. Significant differences in outcome were found when treatment purpose was compared; prevention/promotion (well populations), rehabilitation, or disease management. Three to six months post-baseline, a moderate positive effect of exercise interventions was found for overall QoL in rehabilitation patients (effect size [ES] = 0.55), but no significant effect for well or disease management groups (ES = 0.11 and ES = -0.00 respectively). However, physical and psychological QoL domains improved significantly relative to controls in well participants (ES = 0.22 and ES = 0.21 respectively). Psychological QoL was significantly poorer relative to controls in the disease management group (ES = -0.26). This pattern of results persisted over one year. With some exceptions, better overall QoL was reported for light intensity exercise undertaken in group settings, with greater improvement in physical QoL following moderate intensity exercise. The implications for future practice and research are discussed.