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Increasing numbers of Cigano people in Portuguese schools show that this is the most educated generation to date. However, according to recent data only 2.6% are enrolled in secondary education. Using an intersectional approach examining gender, ethnicity, and family socioeconomic status to explore the youngsters’ academic trajectories, and focusing on tensions of the interplay between structural constraints and individual agency, enables us to explore identity reconfiguration processes (‘in- between’). The data, based on 32 semi-structured interviews, point to three main dimensions regarding the youngsters’ aspirations for social mobility: the school relevance to achieve jobs differing from traditional activities; school perceived as a means to develop important transversal skills, useful in broader citizenship contexts; school as a privileged space for inter-ethnic socialisation, with impact on the youngsters’ school and professional future. Participant heterogeneity explains variations in their aspirations for upward mobility, as well as differentiations in the construction processes of in-between identities. This project is funded by the Foundation for Science and Technology, [PTDC/CED-EDG/30175/ 2017]. info:eu-repo/semantics/publishedVersion

AimTo investigate the diversity and specificity of the determinants of immigrant caregivers’ adherence to child primary care (CPC) health recommendations.BackgroundImmigrant caregiver’s adherence to CPC health recommendations is of utmost importance to minimize their children’s health-related vulnerabilities. Some research has been conducted on the determinants of immigrants’ access to health services, but much less is known about the determinants of their adherence to health professionals’ recommendations once they get there, especially in a primary health care context. This study contributes to bridge these gaps.MethodsInterviews and focus groups were conducted, with immigrant and non-immigrant caregivers living in Portugal (n=35), from heterogeneous socioeconomic backgrounds. Focus group and individual interview scripts were developed to explore caregivers’ understanding and use of CPC services and, particularly, their adherence to CPC recommendations. A socio-demographic questionnaire was also administered. Qualitative data were analyzed using a grounded theory methodology.Findings‘Adherence to CPC health recommendations’ is a core and multidimensional concept. Several determinants were identified at individual, interpersonal, organizational and structural levels. Some determinants were highlighted both by immigrant and non-immigrant caregivers: valuing children’s health, usefulness of recommendations, perceived health-care professionals’ competence, central role of vaccination in CPC and caregivers’ socio-economic conditions. Other determinants were specifically mentioned by immigrant caregivers: expectations about traditional versus pharmacological treatments, cultural mismatches in children’s care practices, perceived quality of Portuguese CPC services versus CPC from countries of origin. These results provide innovative theoretical and empirical contributions to the field of primary health care and, particularly, to immigrant caregivers’ adherence behaviors. Implications for research on treatment adherence in primary care contexts, the development of interventions that promote caregivers’ adherence to CPC health recommendations and for child protection will be discussed.

Immigrants and ethnic minorities have been identified as vulnerable groups in health, in general, and in what concerns therapeutic non-adherence (TA) in particular; i.e., (not)following health-care providers’ therapeutic recommendations. The general aim of this paper is presenting a literature review of immigrants’/ethnic minorities’ TA determinants. We will start by highlighting the reasons as to why immigrants’/ethnic minorities’ therapeutic (non)adherence should be a topic of concern. Then, we will present a review of the main determinants of immigrants’/ethnic minorities’ TA, at different levels of analysis (e.g., broad structural level; social and community networks; material and social conditions) and emphasize that non-adherence among immigrants/ethnic minorities is mostly non-intentional, seeing as how it is associated with issues such as: low socio-economic conditions, language barriers and cultural mismatches. Finally, we will highlight the role of health-care providers in tackling this health-related problem and reflect about the importance of promoting development and training of health-care providers’ multicultural abilities. RESUMO: Os imigrantes e as minorias étnicas têm sido identificados como grupos vulneráveis na área da saúde, em geral, e no que diz respeito à (não)adesão terapêutica, em particular, i.e., (não)seguimento das recomendações dos profissionais de saúde. O objetivo geral deste artigo é o de apresentar uma revisão de literatura sobre os determinantes da (não)adesão terapêutica de imigrantes e minorias étnicas. Inicialmente, destacar-se-ão os motivos pelos quais a (não)adesão terapêutica de imigrantes/minorias étnicas poderá ser considerada como um tema relevante. Seguidamente, apresentar-se-á uma revisão sobre os principais determinantes da (não)adesão de imigrantes/minorias étnicas, em diferentes níveis de análise (e.g., estrutural; redes sociais e comunitárias; condições materiais e sociais) e destacar-se-á que a não-adesão entre os imigrantes/minorias étnicas é sobretudo não-intencional, por se encontrar associada a questões como: condições socioeconómicas desfavoráveis, barreiras linguísticas, desen - contros culturais. Finalmente, salientar-se-á o papel dos profissionais de saúde na resolução deste problema relacionado com a saúde e reflectir-se-á sobre a importância de promover o desenvolvimento e a formação de competências multiculturais por estes profissionais. Fundação para a Ciência e Tecnologia (FCT)

Introduction: Caregivers’ adherence to Child Primary Care (CPC) health recommendations is particularly relevant for the protection of children’s health and promotion of their optimal development. Nevertheless, there are currently no measures to assess it, as the majority of measures are focused on pharmacological treatment adherence instead of adherence to preventive health recommendations. Thus, this paper describes the development and validation of a new instrument to assess caregivers’ adherence to CPC health recommendations regarding children aged between 2 years and 6 years old, which would also be sensitive to the specificities of caregivers in more vulnerable conditions—the CPC-Adherence Scale. Methods: Six hundred sixty-two parents (93.4% women; 6.6% immigrant), living in Portugal and with children aged between 2 years and 6 years, participated in a cross-sectional study using a paper or electronic protocol. The protocol was composed by: (1) the CPC-Adherence Scale; (2) questions regarding experiences in CPC; (3) the European Task Force on Patient Evaluation of General Practice Care (EUROPEP); (4) socio-demographic information. Results: The exploratory and confirmatory factor analyses supported a 2-factor solution: (1) Adherence to a safe psychomotor development (n = 14 items; Cronbach’s Alpha = 0.894); (2) Adherence to nutritional counseling (n = 6 items; Cronbach’s Alpha = 0.608). The CPC-Adherence Scale showed good content and criterion-related validity. It discriminated levels of adherence of caregivers with different levels of knowledge about CPC recommendations, satisfaction with care and different socio-economic and immigrant t status. Discussion: The CPC-Adherence Scale is an innovative and promising measure that may play a relevant role on future research and intervention for the promotion of adherence behaviors in a primary prevention context. info:eu-repo/semantics/acceptedVersion