Health and access to healthcare in homeless people: Protocol for a mixed-methods study.

BACKGROUND: Homelessness is a more complex problem than the simple lack of a place to live. Homeless people (HP) often suffer from poor health and premature death due to their limited access healthcare, and are also deprived of basic human and social rights. The study protocol described here aims to evaluate the complex relationship between homelessness and health, and identify the barriers and facilitators that impact access to healthcare by HP. METHODS: This is a mixed-methods study that uses an explanatory sequential design. The first phase will consist of a cross-sectional study of 300 HP. Specific health questionnaires will be used to obtain information on health status, challenges during the COVID-19 pandemic, self-reported use of healthcare, diagnoses and pharmacologic treatments, substance abuse (DAST-10), diet quality (IASE), depression (PHQ-9), and human basic needs and social support (SSQ-6). The second phase will be a qualitative study of HP using the "life story" technique with purposive sampling. We will determine the effects of different personal, family, and structural factors on the life and health status of participants. The interviews will be structured and defined using Nussbaum's capability approach. DISCUSSION: It is well-known that HP experience poor health and premature death, but more information is needed about the influence of the different specific social determinants of these outcomes and about the barriers and facilitators that affect the access of HP to healthcare. The results of this mixed methods study will help to develop global health strategies that improve the health and access to healthcare in HP.

La construcción de subjetividades en itinerarios de fracaso escolar. Itinerarios de inserción sociolaboral para adolescentes en riesgo / Subjectivity construction in school failure paths. Transition pathways provided for labour insertion for adolescents at risk

La modernización del sistema de Formación Profesional del Estado español se remonta a los años 90. Desde entonces, ha evolucionado significativamente, teniendo los desarrollos europeos como marco de referencia. Con la extensión de la escolarización hasta los 16 años, se introdujo en el año 1994 un tipo de formación profesionalizadora de muy bajo nivel de cualificación, especialmente diseñada para los adolescentes clasificados como de bajo rendimiento académico en Educación Secundaria y para aquellos en situación de vulnerabilidad social. Esta formación fue rediseñada en 2006 y en 2013. Nuestra contribución, enmarcada en una investigación más amplia desarrollada en el seno de un proyecto europeo, ofrece una revisión de la literatura producida alrededor de dichos programas, para así poder comparar la evolución de los 3 tipos de programas formativos en términos de las posibilidades educativas que han ofrecido a los adolescentes que han pasado por ellos. A la luz de estos datos y de los obtenidos en la investigación realizada, presentamos cómo se perfilan las subjetividades adolescentes a través de los discursos de los docentes, el equipo directivo y el equipo orientador que les atienden en los programas de Formación Profesional Inicial en la ciudad de Valencia

The modernization of the vocational education system in Spain dates back to the 90s. Since then, it has evolved significantly, taking the European directives as a frame of reference. With the extension of compulsory schooling until the age of 16, in 1994 a vocational training scheme was introduced within the education system at a very low level of qualification, particularly designed for adolescents classified as low academic performers in secondary education and for adolescents in situation of social vulnerability. Such training scheme was reshaped in 2006 and 2013. Our contribution is framed in a wider research developed within a European Project, aiming to provide a review of the literature produced around these programs, in order to compare the evolution of those 3 types of training provision in terms of the educational possibilities each one has provided for the adolescents that have participated in them. In light of these data and those produced by our research, in this paper we argue how adolescent subjectivities are produced. We rely upon the speech of teachers, head teachers and guidance teams that deal with young people in such training provision in the city of Valencia

Itinerarios de éxito y rupturas en la educación de segunda oportunidad / Successful and unsuccessful pathways in second chance education programmes / Itinerários de sucesso e de rupturas na educação de segunda oportunidade

El concepto “educación de segunda oportunidad” (en adelante Esop) hace referencia a los dispositivos puestos en marcha para luchar contra la exclusión social de aquellas personas (en particular los jóvenes) que han abandonado los estudios con un nivel educativo inferior al de secundaria postobligatoria. Los programas de formación para el empleo dirigidos a jóvenes son los dispositivos de Esop más extendidos en España. En este artículo, se presentan los resultados de una investigación evaluativa de uno de estos programas basada en el método biográfico. El abordaje integral y la individualización, los contenidos de la formación y los aprendizajes realizados, las estrategias metodológicas, el vínculo afectivo y el entorno educativo se manifiestan como determinantes del éxito. También queda patente el impacto positivo de la participación a nivel personal y laboral.

The concept of second chance education (hereafter SCE) refers to the programs launched to combat the social exclusion of people (in particular young people) who have left school with a level of education below upper secondary. Training employment programs aimed at young people are the most widespread SCEs in Spain. The results of an evaluative investigation of one of those programs, based on the biographical method, are shared in this article. A comprehensive educational approach that includes its individualization, training content and the learnings achieved, methodological strategies, emotional ties and the educational environment are identified as determinants of success. Moreover, there is a noticeable positive impact of the young people’s participation on their personal lives and work opportunities

O conceito de “educação de segunda oportunidade” (Esop) faz referência aos dispositivos colocados em funcionamento para lutar contra a exclusão social das pessoas (em particular os jovens) que tenham abandonado os estudos com um nível educativo inferior ao do ensino secundário superior. Os programas de formação profissional dirigidos aos jovens são os dispositivos de Esop mais presentes na Espanha. Neste artigo, apresentam-se os resultados de uma pesquisa avaliativa de um desses programas, com base no método biográfico. A abordagem integrada e a individualização, o conteúdo da formação e os aprendizados obtidos, as estratégias metodológicas, o vínculo afetivo e o ambiente educacional se manifestam como fatores determinantes do sucesso. O impacto positivo da participação a nível pessoal e profissional também é evidente.