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      Salutogenic health promotion program for migrant women at risk of social exclusion

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          Abstract

          Background

          Migrant women at risk of social exclusion often experience health inequities based on gender, country of origin or socioeconomic status. Traditional health promotion programs designed for this population have focused on covering their basic needs or modifying lifestyle behaviors. The salutogenic model of health could offer a new perspective enabling health promotion programs to reduce the impact of health inequities. This study evaluated the effectiveness of a salutogenic health promotion program focused on the empowerment of migrant women at risk of social exclusion.

          Methods

          A four-session salutogenic health promotion program was conducted over a period of 6 months. In a quasi-experimental pre-test post-test design, an ad hoc questionnaire was administered to 26 women to collect sociodemographic data, together with 5 validated instruments: Antonovsky’s Sense of Coherence (SOC-13), Duke-UNC-11 (perceived social support), Quality of Life Short Form-36 (SF-36), Rosenberg’s Self-Esteem Scale, and the Cohen et al. Perceived Stress Scale (PSS-10). Descriptive analysis and multiple linear regression models were performed. Statistical tests were considered significant with a two-tailed p value < 0.05.

          Results

          Participants had a low initial SOC-13 score (60.36; SD 8.16), which did not show significant change after the health promotion program. Perceived social support (37.07; SD 6.28) and mental quality of life also remained unchanged, while physical quality of life increased from 50.84 (SD 4.60) to 53.08 (SD 5.31) ( p = 0.049). Self-esteem showed an increasing trend from 30.14 (SD 4.21) to 31.92 (SD 4.38) ( p = 0.120). Perceived stress decreased from 20.57 (SD 2.91) to 18.38 (SD 3.78) ( p = 0.016). A greater effect was observed at the end of the program in women with lower initial scores for SOC-13 and quality of life and higher initial scores of perceived stress.

          Conclusions

          The health promotion program reduced perceived stress, increased physical quality of life and showed a trend toward increased self-esteem, especially among migrant women with multiple vulnerability factors. The salutogenic model of health should be considered as a good practice to apply in health promotion programs and to be included in national policies to reduce health inequity in migrant populations.

          Electronic supplementary material

          The online version of this article (10.1186/s12939-019-1032-0) contains supplementary material, which is available to authorized users.

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          Most cited references 37

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          The social psychology of stigma.

          This chapter addresses the psychological effects of social stigma. Stigma directly affects the stigmatized via mechanisms of discrimination, expectancy confirmation, and automatic stereotype activation, and indirectly via threats to personal and social identity. We review and organize recent theory and empirical research within an identity threat model of stigma. This model posits that situational cues, collective representations of one's stigma status, and personal beliefs and motives shape appraisals of the significance of stigma-relevant situations for well-being. Identity threat results when stigma-relevant stressors are appraised as potentially harmful to one's social identity and as exceeding one's coping resources. Identity threat creates involuntary stress responses and motivates attempts at threat reduction through coping strategies. Stress responses and coping efforts affect important outcomes such as self-esteem, academic achievement, and health. Identity threat perspectives help to explain the tremendous variability across people, groups, and situations in responses to stigma.
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            Psychometric properties of a European Spanish version of the Perceived Stress Scale (PSS).

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            This paper presents evidence from a heterogeneous sample of 440 Spanish adults, for the reliability and validity of a European Spanish version of the Perceived Stress Scale (PSS), designed to measure the degree to which situations in one's life are appraised as stressful. The European Spanish version PSS (14-item) demonstrated adequate reliability (internal consistency, alpha = .81, and test-retest, r = .73), validity (concurrent), and sensitivity. Additional data indicate adequate reliability (alpha = .82, test-retest, r = .77), validity, and sensitivity of a 10-item short version of the PSS.
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              The Rosenberg Self-Esteem Scale: translation and validation in university students.

              The aim of this study was to translate into Spanish and to validate the Rosenberg Self-Esteem Scale (RSES), completed by 420 university students. Confirmatory factor analysis revealed that the model that best fit the data, both in the total sample and in the male and female subsamples, was the one-factor structure with method effects associated with positively worded items. The results indicated high, positive correlations between self-esteem and the five dimensions of self-concept. The scale showed satisfactory levels of internal consistency and temporal stability over a four-week period. Lastly, gender differences were obtained. These findings support the use of the RSES for the assessment of self-esteem in higher education.
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                Author and article information

                Contributors
                0034972418770 , 0034649139990 , anna.bonmati@udg.edu
                0034620941465 , carme.malagon@udg.edu
                0034616799814 , sandra.gelabert@udg.edu
                0034667722959 , cristina.bosch@udg.edu
                0031317482462 , lenneke.vaandrager@wur.nl
                0034972487968 , mgarcia@idiapjgol.info
                0034972418770 , dolors.juvinya@udg.edu
                Journal
                Int J Equity Health
                Int J Equity Health
                International Journal for Equity in Health
                BioMed Central (London )
                1475-9276
                3 September 2019
                3 September 2019
                2019
                : 18
                Affiliations
                [1 ]ISNI 0000 0001 2179 7512, GRID grid.5319.e, Faculty of Nursing, , University of Girona, ; Emili Grahit, 77, 17071 Girona, Spain
                [2 ]ISNI 0000 0001 2179 7512, GRID grid.5319.e, Health and Health Care Research Group, , University of Girona, ; Emili Grahit, 77, 17071 Girona, Spain
                [3 ]European Training Consortium-Public Health and Health Promotion, Emili Grahit, 77, 17071 Girona, Spain
                [4 ]ISNI 0000 0001 0791 5666, GRID grid.4818.5, Department of Social Sciences, Heath and Society, , Wageningen University & Research, ; Hollandseweg 1, Wageningen, KN 6706 The Netherlands
                [5 ]GRID grid.452479.9, Vascular Health Research Group, Unitat de Suport a la Recerca Girona, , Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAPJGol), ; Girona, Spain
                [6 ]GRID grid.452479.9, Information System for Research in Primary Care (SIDIAP), , Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAPJGol), ; Barcelona, Spain
                [7 ]ISNI 0000 0001 2179 7512, GRID grid.5319.e, Chair of Health Promotion, , University of Girona, ; Emili Grahit, 77, 17071 Girona, Spain
                Article
                1032
                10.1186/s12939-019-1032-0
                6724247
                31481094
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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                © The Author(s) 2019

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