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Asset mapping is a participatory methodology that engages community members in identifying services and settings that promote health and well-being. This study aimed to identify community assets from the perspective of Latinx immigrant families with youth with disabilities. Latinx immigrant families (n = 21) participated in the mapping, followed by a reflection session and an open forum (n = 30). The findings revealed that families identified faith-based organizations and social service agencies as some of the main assets in their communities, while they identified mental health services as the most needed. The results also showed that participants preferred to utilize services and resources that are within walking distance of their homes, provide safe spaces, treat them well, offer bilingual services, do not require documentation, and are affordable. This study has important implications for community scholars and practitioners interested in implementing asset-based methodologies that focus on participants as experts of their own realities and agents of change and that promote advocacy and empowerment actions.
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Pessoas com Deficiência , Emigrantes e Imigrantes , Adolescente , Promoção da Saúde/métodos , HumanosRESUMO
Community-based participatory research (CBPR) approaches to promoting justice focus on working from the ground up and giving a voice to marginalized communities regarding their concerns, potential solutions, and how to address social justice issues that matter to them. The pursuit of justice is often related to efforts to attain personal as well as collective well-being. In this paper, we illustrate three exemplars of community psychologists' efforts to promote justice. Within each case study, we discuss the social and community context and examine how the researchers built partnerships and solidarity, developed ways of doing, and approached challenges and solutions. First, we present an example to promote economic justice through an entrepreneurship initiative developed in collaboration with young Black youth with disabilities in the United States. The second case illustrates an effort to promote reproductive justice in collaboration with Roma women and girls in Spain. The third exemplar depicts the use of life stories as a method to raise the voices of displaced, marginalized indigenous women in Peru. Based on these three case studies, we present a synthesis model of social justice. We also discuss implications for future studies emphasizing the importance of engaging community participants in research meaningful ways, developing sustainable partnerships, and decolonizing research.
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Roma (Grupo Étnico) , Justiça Social , Adolescente , Pesquisa Participativa Baseada na Comunidade/métodos , Feminino , Humanos , Peru , Espanha , Estados UnidosRESUMO
The pervasive failure of policies aimed at overcoming health inequities suffered by European Roma reflects the oppressive and impoverished living conditions of many ethnic minorities in the Western world. The multiple social inequities that Roma experience and the cumulative effect on their health prove that the failure of health policies that impact Roma must be attributed to their ameliorative nature. These policies legitimize the mechanisms of oppression that sustain inequities, fueling fatalistic attitudes toward minorities, while these minorities internalize the stigma and attempt to survive on the margins of society. This paper presents the RoAd4Health project, a community initiative in which academic researchers partnered with Roma communities to overcome health inequities. We present the multiple methods utilized for building meaningful advocacy, such as photovoice and asset mapping led by Roma agents of change. These methods provided the capacity to develop a local narrative of disparities, build alliances to gain capacity to respond to injustices, and take actions to promote social change. The results of effectively involving all significant stakeholders (i.e., community agents of change, residents, health and social care providers, Roma community grassroots organizations, and institutional actors) are discussed along with lessons learned.
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Relações Comunidade-Instituição , Etnicidade , Equidade em Saúde , Adolescente , Adulto , Serviços de Saúde Comunitária , Feminino , Política de Saúde , Acessibilidade aos Serviços de Saúde , Disparidades nos Níveis de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Grupos Minoritários , Narração , Fotografação , Roma (Grupo Étnico) , Estigma Social , Espanha , Adulto JovemRESUMO
BACKGROUND: Europe is becoming more social and cultural diverse as a result of the increasing migration, but the medical doctors are largely unprepared. The medical education programmes and teachers have not evolved in line with development of the population. Culturally competent curricula and teachers are needed, to ensure cultural competence among medical doctors and to tackle inequalities in health between different ethnic groups. The objective of this EU financed study is therefore to provide a snapshot of the role of cultural competence in European medical educational programmes. METHODS: A questionnaire was developed in order to uncover strengths and weaknesses regarding cultural competence in the European medical education programmes. The questionnaire consisted of 32 questions. All questions had an evidence box to support the informants' understanding of the questions. The questionnaire was sent by email to the 12 European project partners. 12 completed questionnaires were returned. RESULTS: Though over half of the participating medical programmes have incorporated how to handle social determinants of health in the curriculum most are lacking focus on how medical professionals' own norms and implicit attitudes may affect health care provision as well as abilities to work effectively with an interpreter. Almost none of the participating medical programmes evaluate the students on cultural competence learning outcomes. Most medical schools participating in the survey do not offer cultural competence training for teachers, and resources spent on initiatives related to cultural competences are few. Most of the participating medical programmes acknowledge that the training given to the medical students is not adequate for future jobs in the health care service in their respective country regarding cultural competence. CONCLUSIONS: Our results indicate that there are major deficiencies in the commitment and practice within the participating educational programs and there are clear potentials for major improvements regarding cultural competence in programmes. Key challenges include making lasting changes to the curriculum and motivating and engaging stakeholders (teachers, management etc.) within the organisation to promote and allocate resources to cultural competence training for teachers.
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Competência Cultural/educação , Currículo , Educação Médica/organização & administração , Docentes de Medicina , Faculdades de Medicina , Atitude do Pessoal de Saúde , Diversidade Cultural , Educação Médica/normas , Europa (Continente) , Docentes de Medicina/organização & administração , Docentes de Medicina/psicologia , Humanos , Estudantes de Medicina , Inquéritos e QuestionáriosRESUMO
This study examines the individual and contextual factors associated with sociopolitical control expressed by immigrants in southern Spain. We used hierarchical linear modeling to evaluate the relations between individual (community participation, social connectedness, and perceived cultural competence of receiving community services) and municipality characteristics (city community participation, city social connectedness, and city community services' cultural competence) and immigrants' feelings of sociopolitical control. Data were analyzed using a two-level model based on 707 Moroccan immigrants in 25 municipalities. After adjusting for gender, educational level, and psychosocial confounding factors, we observed a positive association between social connectedness and sociopolitical control at the individual level. At the contextual level, we observed a positive association between (a) city community participation, (b) city social connectedness, and (c) city community services' cultural competence, and sociopolitical control. Indeed, living in a municipality where there are community services with high levels of cultural competence and where, on average, many people participate in organizations and neighbors are connected, was associated with higher levels of perceived control in the sociopolitical domain for immigrants. We also discuss implications for community-based research and practice.
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Emigrantes e Imigrantes , Emigração e Imigração , Política , Controle Social Formal , Adulto , Competência Cultural/psicologia , Emigração e Imigração/legislação & jurisprudência , Feminino , Humanos , Masculino , Marrocos/etnologia , Identificação Social , Participação Social , EspanhaRESUMO
The decision to migrate is normally based on expectations of improving one's actual living conditions and therefore, one's well-being. However, these expectations are not usually met in receiving contexts that relegate newcomers to lower power positions. From a liberating community psychology approach, this study aims to develop a predictive model of the well-being of Moroccan migrants living in southern Spain. Data were collected from a survey sample of 633 migrants (the average age was 31.9 years and 51.8 % were women) from 20 territorial units of Andalusia. Through a process of multilevel regression analysis, this study reveals that the well-being of the Moroccan community is closely determined by the following: (a) the level of social justice in the receiving context (openness to diversity of receiving communities, cultural sensitivity of community services, and residential integration); and (b) the individual strengths of the population (use of active coping strategies, satisfaction with the receiving context, and temporal stability in the new environment). These results empirically support the impact that different ecological levels of analysis have on well-being. Major theoretical contributions of the model and useful suggestions for improving migrant well-being are discussed.
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Emigrantes e Imigrantes/psicologia , Saúde Mental , Satisfação Pessoal , Justiça Social/psicologia , Estresse Psicológico/psicologia , Adaptação Psicológica , Adulto , Feminino , Humanos , Masculino , Modelos Psicológicos , Marrocos/etnologia , Análise Multinível , Preconceito/psicologia , Análise de Regressão , Marginalização Social/psicologia , Espanha , Adulto JovemRESUMO
Despite the last few decades' advances towards social and gender justice, reproductive decisions are still a source of oppression for many European Romani women and girls. This protocol aims to propose a model to empower Romani women and girls' reproductive decisions, inspired by Reproductive Justice-the recognition of women and girls' ability to make safe and free decisions about their bodies and reproduction. Through Participatory Action Research, 15-20 Romani girls and their families, two Romani platforms, and key agents from a rural and an urban context in Spain will participate. They will (1) contextualize Romani women and girls' inequities, (2) build partnerships, (3) implement Photovoice and advocate for their gender rights, and (4) assess the initiative's related changes, using self-evaluation techniques. Qualitative and quantitative indicators will be collected to assess impacts among participants, while tailoring and assuring the quality of the actions. Expected outcomes include the creation and consolidation of new social networks, and the promotion of Romani women and girls' leadership. For this, Romani organizations must be transformed into empowering settings for their communities, spaces where Romani women and girls assume responsibility of the initiatives, being these tailored to their real needs and interests, and guaranteeing transformative social changes.
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Latino immigrant families with children with disabilities experience multiple sources of oppression during their settlement process in the United States. Unfair social structures and dominant cultural values and norms and the way they influence the immigrants' personal life stories generate a cycle of oppression very difficult to break. This paper presents a case study of how a group of Latino parents carried out a process of liberation fueled by the generation of empowering community narratives (critical awareness leading to transformative action) that resulted from a community-university partnership. Participants initiated a process that led them to discover their own stories of oppression and create new stories; to deconstruct the dominant cultural narratives and modify existing ones; and to understand contexts for power sharing. This joint reflection and increased awareness propelled group members to take action by founding a grassroots organization to redress some of the injustices that were partly responsible for their oppression, thus generating shifts at the personal, relational, and collective levels. In light of the theory of liberation, we discuss the participants' development of critical awareness that led them to take action to address their unmet needs.
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Emigrantes e Imigrantes/psicologia , Hispânico ou Latino/psicologia , Pais/psicologia , Pessoas com Deficiência Auditiva/psicologia , Poder Psicológico , Criança , Pré-Escolar , Crianças com Deficiência/psicologia , Humanos , Estados UnidosRESUMO
The objective of this study is to adapt and translate into Spanish Spreitzer's Psychological Empowerment Scale (1995a). A process of translation and reverse-translation was applied to the scale's items, whose psychometric properties were then examined using a sample of 272 professional nurses at public hospitals in the province of Seville. The data were subjected to confirmatory factor analysis. The significance of the factor loadings demonstrated the need to create a new model eliminating one item. The 11-item model was shown to possess adequate construct validity and internal consistency. The results confirm the original, four-factor structure obtained by Spreitzer, with the exception of item 10, and support the utilization of the Spanish version of this scale in the workplace. Future research should more extensively investigate its construct validity, and test the nomological network of the operationalized construct within the field of psychological well-being and in the context of the workplace.
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Enfermeiras e Enfermeiros/psicologia , Poder Psicológico , Adulto , Feminino , Humanos , Idioma , Masculino , Pessoa de Meia-Idade , Psicometria/instrumentação , Reprodutibilidade dos Testes , Local de Trabalho/psicologiaRESUMO
The objective of this article is to describe the impact of the COVID-19 pandemic on the implementation of the RoMoMatter project, using a community-based participatory action research methodology, in Córdoba (Spain). Five academic researchers and 30 community members participated. Individual interviews, focus groups and field notes were used as data collection techniques. The interviews were audio-recorded with the consent of the participants and transcribed verbatim. The information collected was coded using Atlas Ti software. The efforts of adaptation to the new pandemic scenario made by the participants and the technical and emotional support role played by the adaptation team are highlighted. It is concluded that the main impact of the pandemic was evidenced in the participatory process of all the people involved, and in the format and number of activities.
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This paper describes an acculturative integration approach that stresses the contribution of liberation psychology. Immigrant integration is a challenge for receiving countries in the Western world due to the frequent asymmetrical and oppressive conditions suffered by newcomers in their new settlements. The cross-cultural perspective connects integration with psychological acculturation, emphasizing harmony between acquisitions of the new culture while maintaining cultural heritage, and creating opportunities for intergroup relationships. In turn, liberation psychology permits an understanding of the acculturative transition as an empowerment and self-construction process by which immigrants acquire a new vision of the world and of themselves, transforming both structural conditions and themselves. From this perspective we conceptualize acculturative integration as the process by which newcomers become an accepted part of the new society through a reflexive and evaluative process, changing their social references and position, rebuilding their social and personal resources, and achieving a new agency in coherence with their new challenges and goals. In this process, they acquire critical thinking about unequal conditions, gain capacities to respond to the inequalities, and take effective actions to confront them. We illustrate this process using the narratives of nine Moroccan women who are living in asymmetrical and oppressive local contexts in Andalusia, the southern-most region of Spain.
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Aculturação , Migrantes/psicologia , Humanos , Relações Interpessoais , Saúde Mental , Modelos Psicológicos , Marrocos/etnologia , Política , Poder Psicológico , Psicologia Social , Identificação Social , Participação Social/psicologia , EspanhaRESUMO
Aim: To present a protocol study directed at tackling gender discrimination against Roma girls by empowering their mattering so they can envision their own futures and choose motherhood only if-and when-they are ready. Background: Motherhood among Roma girls (RGM) in Europe impoverishes their lives, puts them at risk of poor physical and mental health and precipitates school dropouts. Overwhelming evidence affirms that the conditions of poverty and the social exclusionary processes they suffer have a very important explanatory weight in their sexual and reproductive decisions. Methods: Through a Community-based Participatory Action Research design, 20-25 Roma girls will be recruited in each one of the four impoverished communities in Bulgaria, Romania and Spain. Data collection and analysis: Desk review about scientific evidences and policies will be carried out to frame the problem. Narratives of Roma women as well as baseline and end line interviews of girl participants will be collected through both qualitative and quantitative techniques. Quantitative data will be gathered through reliable scales of mattering, socio-political agency, satisfaction with life and self. A narrative analysis of the qualitative information generated in the interviews will be carried out. Expected results: (1) uncover contextual and psychosocial patterns of girl-motherhood among Roma women; (2) build critical thinking among Roma girls to actively participate in all decisions affecting them and advocate for their own gender rights within their communities; and (3) empower Roma girls and their significant adults to critically evaluate their own initiatives and provide feedback to their relevant stakeholders. Conclusions: Roma girls will improve their educational aspirations and achievements and their social status while respecting and enhancing Roma values.
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Poder Psicológico , Saúde Reprodutiva/legislação & jurisprudência , Direitos Sexuais e Reprodutivos , Roma (Grupo Étnico)/psicologia , Justiça Social , Adulto , Pesquisa Participativa Baseada na Comunidade , Etnicidade/psicologia , Europa (Continente) , Feminino , Equidade em Saúde , Promoção da Saúde/métodos , Pesquisa sobre Serviços de Saúde , Disparidades em Assistência à Saúde , Humanos , Estigma SocialRESUMO
Europe is in the process of building a more participative, just, and inclusive European Union. The European Social Fund, which is an initiative developed to actively promote multinational partnerships that address pressing social issues, is a good example of the European transformation. This article describes the steps taken to develop and evaluate the activities of an international network promoting collaborative capacity among regional partners involved in the prevention of labor discrimination toward immigrants in three European countries-Spain, Belgium, and Italy. An international team of community psychologists proposed an empowering approach to assess the collaborative capacity of the network. This approach consisted of three steps: (1) establishing a collaborative relationship among partners, (2) building collaborative capacity, and (3) evaluating the collaborative capacity of the network. We conclude with lessons learned from the process and provide recommendations for addressing the challenges inherent in international collaboration processes.
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Redes Comunitárias , Cooperação Internacional , Psicologia , União Europeia , Humanos , Papel Profissional , Avaliação de Programas e Projetos de SaúdeRESUMO
OBJECTIVE: To describe the challenges, resources and strategies of the staff of the family planning programme of the Polígono Sur Healthcare Centre in Seville (Spain) in their care of Roma women. METHOD: This is a descriptive study in which in-depth interviews and discussion groups were held with all programme professionals, including a documentary review of the programme. The information was analyzed based on the Roma Health Integration Policy Index, a tool that evaluates the entitlement, accessibility, sensitivity and capacity for change of health programmes for the Roma population. RESULTS: The professionals encountered multiple challenges to implement the family planning programme with Roma women due to the characteristics of the users and the low sensitivity of the programme towards them. The absence of specific actions for Roma women within the family planning programme, agreed to by the healthcare district, obliges professionals to develop adaptations and strategies to ensure quality sexual and reproductive health services for their users. CONCLUSIONS: It is necessary to adapt sexual and reproductive health programmes targeted at Roma women by (a) detecting, evaluating, systematizing and disseminating good practices, (b) developing actions that address the multiple vulnerabilities of Roma women, (c) acknowledging professionals who advocate for the health of these women within their organizations, and (d) promoting reproductive justice as the goal of these programmes.
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Serviços de Planejamento Familiar , Saúde Reprodutiva , Roma (Grupo Étnico) , Saúde Sexual , Instituições de Assistência Ambulatorial , Serviços de Planejamento Familiar/organização & administração , Feminino , Humanos , Saúde Reprodutiva/normas , Saúde Sexual/normas , EspanhaRESUMO
Addressing health disparities and promoting health equity for Roma has been a challenge. The Roma are the largest disadvantaged ethnic minority population in Europe and have been the victims of deep social and economic injustices, institutional discrimination, and structural antigypsyism over many centuries. This has resulted in a much worse health status than their non-Roma counterparts. Current strategies based on ameliorative and top-down approaches to service delivery have resulted in paradoxical effects that solidify health disparities, since they do not effectively address the problems of vulnerable Roma groups. Following a health justice approach, we present a community-based participatory action research case study generated by a community and university partnership intended to address power imbalances and build collaboration among local stakeholders. This case study involved a group of health providers, Roma residents, researchers, Roma community organizations, and other stakeholders in the Poligono Sur, a neighborhood of Seville, Spain. The case study comprises four phases: (1) identifying Roma health assets, (2) empowering Roma community through sociopolitical awareness, (3) promoting alliances between Roma and community resources/institutions, and (4) building a common agenda for promoting Roma health justice. We highlighted best practices for developing processes to influence Roma health equity in local health policy agendas.
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Pesquisa Participativa Baseada na Comunidade/métodos , Equidade em Saúde , Política de Saúde , Disparidades em Assistência à Saúde , Roma (Grupo Étnico)/psicologia , Roma (Grupo Étnico)/estatística & dados numéricos , Justiça Social , Etnicidade/psicologia , Etnicidade/estatística & dados numéricos , Promoção da Saúde/métodos , Humanos , Grupos Minoritários/psicologia , Grupos Minoritários/estatística & dados numéricos , Estigma Social , EspanhaRESUMO
This themed issue focuses on understanding and addressing several public health issues affecting communities today nationally and internationally. Health disparities, and global health in general, cover a large breadth of health concerns impossible to address in one issue. Here we provide a scope of some health disparities while focusing on health promotion and well-being of diverse populations, specifically within urban undeserved populations, rural communities in Peru, Roma minorities in Spain, and refugee communities. We focus on understanding contextual issue that affect health disparities as well as on examining the effectiveness of community-based interventions and community coalitions designed to address disparities.
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Serviços de Saúde Comunitária , Promoção da Saúde , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde , Saúde Global , Política de Saúde , Acessibilidade aos Serviços de Saúde , Humanos , Peru , Refugiados , EspanhaRESUMO
The health inequities suffered by the Roma population in Europe represent an alarming and unacceptable source of injustice. As the main ethnic minority in Europe, the gap between the health conditions of the Roma and the rest of the population poses a challenge to human rights and public health. Many political efforts have been deployed in Europe to tackle these inequities. However, they have fallen short, even causing paradoxical consequences. In this paper, we argue that previous political efforts have failed because they were developed from a neoliberal perspective, which perceives Roma health inequities as isolated ethnic problems for which there is no political accountability. Hence, there is a need for transformative political change that results in the protection of rights and self-governance to address health inequities experienced by Roma people. We propose a framework of health governance guided by the following principles: (a) effective involvement of multiple stakeholders by building collaborative capacity; (b) infusion of health perspectives in all policies and multisectoral actions;
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Política de Saúde , Disparidades nos Níveis de Saúde , Política , Roma (Grupo Étnico) , Bulgária , Acessibilidade aos Serviços de Saúde , Disparidades em Assistência à Saúde , Humanos , Hungria , Roma (Grupo Étnico)/psicologia , Romênia , Justiça SocialRESUMO
Community engagement of migrants has been identified as an important element in developing both individual well-being and cohesive multicultural receiving communities. Through 10 in-depth interviews, this study explores the profile of Moroccan migrant leaders in community organizations in the receiving context (south of Spain) and the reasons for which they engage. Moreover, it analyzes the relationship established between community engagement and their well-being. The results show that migrants commit for both intrinsic (e.g., support their compatriots) and extrinsic (e.g., increase their social connection) reasons. Their social action has a positive influence on their well-being because it activates the following paths: (1) improvement of bicultural competences; (2) development of social relationships with receiving members; (3) strengthening of social bonds with compatriots; (4) increase of abilities in dealing with unjust social conditions in the new environment; and (5) decrease of prejudice towards their own cultural group.
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Liderança , Comportamento Social , Migrantes , Adulto , Características Culturais , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Marrocos/etnologia , EspanhaRESUMO
The cultural competence training (CCT) of health care professionals represents a useful resource to face the challenges involved in health care assistance for multicultural populations. However, the traditional perspective has shown limited results, as it does not consider professionals in their contexts and avoids continuous assessment processes. In response to these limitations, we describe a model of CCT implemented by two professors of the Faculty of Nursing at the University of Seville in Spain as a psychopolitical empowerment process, and exemplified by the experience of the emergency nurses at the Virgen Macarena Hospital. This process adds the notion of power to traditional CCT and uses dialogic learning to: (a) state a mission and develop critical thinking; (b) take stock of the actions for change and increase the capacity of nurses to respond; and (c) motivate nurses to plan the future and take action. As a result, professionals become a learning community, able to develop a new professional identity and role, and can also implement actions for the transformation of health care settings.
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Assistência à Saúde Culturalmente Competente , Enfermagem em Emergência/educação , Papel do Profissional de Enfermagem , Poder Psicológico , Adulto , Diversidade Cultural , Feminino , Humanos , Capacitação em Serviço , Masculino , EspanhaRESUMO
OBJECTIVE: To identify and describe the needs and problems of the immigrant population related to access and utilization of health services. METHOD: A descriptive, qualitative, phenomenological study was conducted using focus groups. The study area was the county of Campo de Gibraltar (Spain), which represents the gateway to Europe for immigration from Africa. The final sample size (51 immigrants from 11 countries) was determined by theoretical saturation. A narrative analysis was conducted with QSR NVivo9 software. RESULTS: Immigrants' discourse showed four categories of analysis: response to a health problem, system access, knowledge of social and health resources, and health literacy needs. Responses to health problems and the route of access to the health care system differed according to some sociodemographic characteristics (nationality/culture of origin, length of residence, and economic status). In general, immigrants primarily used emergency services, hampering health promotion and prevention. The health literacy needs identified concerned language proficiency and the functioning of the health system. CONCLUSIONS: There is a need to promote interventions to enhance health literacy among immigrants. These interventions should take into account diversity and length of residence, and should be based on an action-participation methodology.